Effect of different frequencies of intermittently scanned continuous glucose monitoring on glycemic control in adults with type 2 diabetes not using insulin: The COMPASS-libre randomized controlled trial.

BACKGROUND AND

OBJECTIVE

Intermittently scanned continuous glucose monitoring (isCGM) has been shown to improve glycemic control in individuals with type 2 diabetes mellitus (T2DM), yet the optimal frequency of CGM use remains unclear, particularly in community pharmacy settings. This study evaluated the effects of different frequencies of isCGM use within a brief pharmacist-led educational program for adults with T2DM treated without insulin.

METHODS

The COMPASS-Libre study was a multicenter, open-label randomized controlled trial conducted in community pharmacies in Japan. Adults with T2DM and glycated hemoglobin (HbA1c) ≥7% were randomized (1:1) to either a single-CGM group (one sensor) or a multiple-CGM group (four sensors) over 12 weeks. The primary outcome was change in time in range (TIR; glucose 70-180 mg/dL). Secondary outcomes included time above range (TAR), time below range (TBR), glucose management indicator (GMI), and coefficient of variation (%CV), along with behavioral and patient-reported outcomes.

RESULTS

Seventy-seven participants were randomized (mean age 60.9 ± 10.4 years; mean HbA1c 7.4 ± 0.8%), with a dropout rate of 16.8%. TIR significantly improved in both the single-CGM group (64.6 ± 23.0% to 71.1 ± 17.9%, P = 0.0496) and the multiple-CGM group (62.5 ± 20.8% to 69.6 ± 21.7%, P = 0.002), with no significant between-group difference in change (6.4 ± 17.1% vs 7.3 ± 12.0%, P = 0.808). TAR decreased significantly in both groups, while TBR remained low and unchanged. GMI also improved in both groups, with no significant between-group differences. Improvements in dietary behavior were observed only in the multiple-CGM group (P = 0.032).

CONCLUSIONS

A brief pharmacist-led educational program using intermittently scanned CGM improved glycemic metrics in adults with non-insulin-treated T2DM. However, increasing the frequency of CGM use did not provide additional glycemic benefit compared with a single CGM exposure. These findings suggest that even limited CGM use may support behavioral change and glycemic improvement in community pharmacy settings.

TRIAL REGISTRATION: UMIN000048893.