{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:04:00Z","timestamp":1779789840000,"version":"3.53.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015769","name":"Dexcom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Although continuous glucose monitoring (CGM) in adults with type 2 diabetes (T2D) has known glycemic benefits, the underlying behavioural and psychosocial processes driving these outcomes remain poorly understood. We examined how CGM influences patient\u2010reported outcomes and whether changes in those outcomes predict glycemic improvement.<\/jats:p>\n <\/jats:sec>\n \n Research Design and Methods<\/jats:title>\n This 6\u2010month prospective observational study included 115 adults with T2D and elevated HbA1c who did not use fast\u2010acting insulin and initiated CGM through a real\u2010world program. At baseline, 3\u2010 and 6\u2010months, HbA1c, medication use\/changes and key psychosocial and self\u2010care behaviours were assessed. Longitudinal structural equation models assessed changes over time and predictors of HbA1c reduction. Post hoc moderation analyses explored whether the effect of self\u2010care behaviour improvements on HbA1c outcomes depended upon new medication starts at baseline.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n HbA1c declined significantly from 9.4% (79\u2009mmol\/mol) at baseline to 7.3% (56\u2009mmol\/mol) at both 3 and 6\u2009months (\n p<\/jats:italic>\n s\u2009<\u20090.001). Participants reported increased diabetes engagement, reduced distress, increased physical activity, fewer missed medications and less overeating (\n p<\/jats:italic>\n s\u2009<\u20090.001). In multivariate models, greater HbA1c reduction was independently predicted by: (1) starting a new diabetes medication in the few months before baseline (\n b<\/jats:italic>\n \u2009=\u2009\u22121.06,\n p<\/jats:italic>\n \u2009<\u20090.001); (2) increases in physical activity (\n b<\/jats:italic>\n \u2009=\u2009\u22120.13,\n p<\/jats:italic>\n \u2009=\u20090.040); and (3) improvements in medication\u2010taking (\n b<\/jats:italic>\n \u2009=\u20092.33,\n p<\/jats:italic>\n \u2009<\u20090.001). Post hoc moderation analysis revealed that behaviour changes were most predictive of glycemic benefit among participants who had\n not<\/jats:italic>\n started a new diabetes medication pre\u2010baseline.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Real\u2010world CGM initiation was associated with significant improvements in glycemic control, self\u2010care behaviours and psychosocial outcomes. Behaviour change\u2014notably, improved diet and physical activity\u2014was a key contributor to glycemic gains, particularly among those not undergoing medication adjustments prior to CGM initiation. These findings support CGM as a catalyst for engagement and behaviour change in T2D management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/edm2.70236","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:29:37Z","timestamp":1778480977000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How\n CGM<\/scp>\n Use in Adults With Type 2 Diabetes Leads to Glycemic Benefits: The Role of Medication and Behaviour Change"],"prefix":"10.1002","volume":"9","author":[{"given":"William H.","family":"Polonsky","sequence":"first","affiliation":[{"name":"Behavioral Diabetes Institute San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor L.","family":"Clark","sequence":"additional","affiliation":[{"name":"Behavioral Diabetes Institute San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Soriano","sequence":"additional","affiliation":[{"name":"Scripps Whittier Diabetes Institute, Scripps Health La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Edgington","sequence":"additional","affiliation":[{"name":"Hancock Public Health Findlay Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron M.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Blanchard Valley Health System Findlay Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E.","family":"Fox","sequence":"additional","affiliation":[{"name":"Blanchard Valley Health System Findlay Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Grace","sequence":"additional","affiliation":[{"name":"Dexcom San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06107-6"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"S358","article-title":"Standards of Care in Diabetes\u20142026","volume":"49","author":"American Diabetes Association","year":"2026","journal-title":"Diabetes Care"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2012.0298"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816643542"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2020.0666"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231198533"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/ds21-0067"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15608"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15519"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2855"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.7444"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892\u2010021\u201001408\u20101"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0612"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/cd24-0030"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.7.943"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/doc25-0053"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2021.108103"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12040"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2017.11.007"},{"key":"e_1_2_11_21_1","volume-title":"Mplus User's Guide","author":"Muth\u00e9n L. K.","year":"2017"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/14746514040040021001"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0419"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.39278"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1304"}],"container-title":["Endocrinology, Diabetes & Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/edm2.70236","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/edm2.70236","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/edm2.70236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:19:14Z","timestamp":1779787154000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/edm2.70236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":24,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/edm2.70236"],"URL":"https:\/\/doi.org\/10.1002\/edm2.70236","archive":["Portico"],"relation":{},"ISSN":["2398-9238","2398-9238"],"issn-type":[{"value":"2398-9238","type":"print"},{"value":"2398-9238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70236"}}