Continuous glucose monitoring has long been associated with tighter control in Type 1 diabetes, but its value across the far larger Type 2 population — including those not on insulin — has remained contested. A comprehensive review now consolidates five years of evidence and makes a compelling case that CGM belongs in mainstream T2D care, while exposing a troubling implementation gap that undermines its potential at scale.
Drawing on studies published between 2020 and 2025, the review finds that CGM use in adults with Type 2 diabetes is consistently linked to meaningful reductions in glycosylated hemoglobin and improvements in time-in-range metrics — the two gold-standard glycemic benchmarks — across both insulin-dependent and non-insulin treatment regimens. Crucially, emerging observational data point toward reductions in all-cause mortality and acute healthcare utilization, outcomes that extend well beyond glucose control. Economic analyses across multiple payer environments classify CGM as a high-value intervention, meaning the clinical return justifies the cost relative to alternatives. Yet uptake remains highly uneven, stratified by age, racial and ethnic background, insurance type, and clinical setting.
This review arrives at a pivotal moment. The recent FDA clearance of over-the-counter CGM devices opens a potential channel for broader adoption without requiring a prescribing clinician, though whether this reaches underserved populations without targeted policy support is uncertain. The mortality signal, while drawn from observational data and therefore not yet causal, is clinically significant enough to warrant attention — prior reviews had largely confined outcomes to surrogate markers like HbA1c. The persistent racial and socioeconomic disparities documented here echo patterns seen across diabetes technology broadly and represent a structural problem that device innovation alone will not solve. Primary care and safety-net settings — where the majority of T2D patients receive care — remain underleveraged deployment environments. This review is confirmatory and synthesizing rather than paradigm-shifting, but its breadth and policy framing make it a useful anchor for clinicians and health systems weighing CGM expansion decisions.