Background <p>Real-time continuous glucose monitoring (RT-CGM) is increasingly used to support glycemic optimization and enhance diabetes self-management. However, evidence regarding its clinical and behavioral effects in adults with type 2 diabetes (T2D) who are not using intensive insulin therapy remains limited.</p> Methods <p>This prospective, single-arm, 12-week study evaluated adults with T2D and suboptimal glycemic control (HbA1c &gt; 7.0%) who were not using intensive insulin therapy and subsequently initiated RT-CGM. Clinical, metabolic, and glycemic parameters, as well as patient-reported outcomes assessed using the Diabetes Self-Management Questionnaire (DSMQ), were recorded. CGM metrics, including time in range (%TIR_70–180), time above range (%TAR), time below range (%TBR), glucose management indicator (GMI), and the Glycemia Risk Index (GRI) with its components, were analyzed at 30 and 90&#xa0;days.</p> Results <p>A total of 118 participants were included in the study. RT-CGM use was associated with improved HbA1c (MD − 0.44%, <i>p</i> &lt; <i>0.001</i>). Body weight decreased modestly (MD − 0.76&#xa0;kg), and capillary glucose declined (MD − 18.75&#xa0;mg/dL). Basal insulin–treated users showed a reduction in daily dose (MD − 4.78 U/day), with a similar decrease in twice-daily insulin users (MD − 5.2 U/day; p &lt; 0.001). RT-CGM use was associated with higher %TIR_70–180 (MD + 4.68%), reductions in %TBR and %TAR, and concurrent improvements in %GMI and GRI (all <i>p</i> &lt; <i>0.001</i>). The DSMQ total raw score improved (MD + 4.09), and the total scale score increased (MD + 0.85).</p> Conclusion <p>Twelve weeks of RT-CGM use were associated with improvements in glycemic control, reductions in insulin requirements, favorable changes in CGM-derived risk metrics, and enhanced diabetes self-management behaviors in adults with T2D managed with non-intensive insulin regimens.</p>