356-OR: A Randomized Controlled Trial Using Continuous Glucose Monitoring (CGM) to Guide Food Choices and Diabetes Self-Care in People with Type 2 Diabetes Not Taking Insulin

Background: CGM is established as an effective tool for those with T2D on insulin. This study evaluated the effect of using CGM to reduce hyperglycemia in people not taking insulin, by focusing on food and lifestyle choices. Methods: A randomized, prospective, four-center study was conducted. The primary endpoint was reduction in % time with glucose 180 mg/dL (TAR) at 3 months. Seventy-two adults not on insulin or sulfonylurea therapy, with glycated hemoglobin (HbA1c) 7.5-12%, were randomized to use CGM alone (n=31) or CGM with a connected food logging app (n=41) to aid diabetes management. There were 3 to 4 education and CGM data-review visits over 90 days. Within and between arm differences in CGM metrics, HbA1c, and body weight were compared. Results: Study groups improved TAR by 28% (CGM) and 23% (CGM + app) and % time with glucose 70-180 mg/dL (TIR) by 27% (CGM) and 23% (CGM + app) while keeping % time 70 mg/dL (TBR) below 1% (Table). No differences were observed between groups. Additionally, both groups had reductions in HbA1c of at least 1.0% and weight of at least 4lbs. Participants using the food app logged an average of 15 meals per week over 90 days. Conclusion: People with T2D not using insulin showed large, clinically significant improvements in CGM metrics and HbA1c when using either CGM alone or CGM plus a food logging application. Disclosure T.W. Martens: Research Support; Abbott. Other Relationship; Abbott. Advisory Panel; Dexcom, Inc. Research Support; Dexcom, Inc., Insulet Corporation, Lilly Diabetes. Other Relationship; Lilly Diabetes. Advisory Panel; Lilly Diabetes. Research Support; Medtronic, Novo Nordisk. Other Relationship; Novo Nordisk. Research Support; Sanofi. Advisory Panel; Sanofi. Other Relationship; Sanofi. Research Support; Tandem Diabetes Care, Inc. H.J. Willis: Research Support; Abbott. Other Relationship; Abbott. Research Support; Academy of Nutrition and Dietetics, Dexcom, Inc. D.F. Kruger: Advisory Panel; Abbott. Research Support; Beta Bionics, Inc., Carmot Therapeutics, Inc. Speaker's Bureau; Dexcom, Inc. Advisory Panel; Dexcom, Inc., Lilly Diabetes. Speaker's Bureau; Lilly Diabetes. Advisory Panel; Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; MannKind Corporation, Novo Nordisk. Speaker's Bureau; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Provention Bio, Inc. Speaker's Bureau; Sanofi, Xeris Pharmaceuticals, Inc. Advisory Panel; Pendulum Therapeutics. Research Support; Tandem Diabetes Care, Inc. Advisory Panel; Cequr. Speaker's Bureau; Cequr. Advisory Panel; Medtronic, embecta, Ascensia Diabetes Care. Research Support; Abbott. Advisory Panel; Sanofi. E. Karslioglu-French: Research Support; Abbott, Pfizer Inc. D.W. Steenkamp: Consultant; Abbott. Research Support; Novo Nordisk A/S, MannKind Corporation, Tandem Diabetes Care, Inc. Funding Abbott Diabetes Care