Use of Flash Continuous Glucose Monitoring Is Associated With A1C Reduction in People With Type 2 Diabetes Treated With Basal Insulin or Noninsulin Therapy

Health Care Disparities in Use of Continuous Glucose Monitoring

Numerous studies have demonstrated that use of continuous glucose monitoring (CGM) improves glycemic control and reduces diabetes-related hospitalizations and emergency room service utilization in individuals with diabetes who are treated with intensive insulin regimens. Recent studies have revealed disparities in use of CGM within racially and ethnically diverse and lower socioeconomic populations, leading to underutilization of CGM in these populations. This article reviews the scope and impact of these disparities on utilization of CGM and explores the factors that may be contributing to this issue.

Just Because You Can, Doesn't Mean You Should … Now. A Practical Approach to Counseling Persons with Diabetes on Use of Optional CGM Alarms

Advances in glucose monitoring technologies have led to the development of different types of continuous glucose monitoring (CGM) platforms: traditional CGM and flash CGM. Both platforms provide critical glucose data that enable persons with diabetes (PwDs) to make more informed decisions in their self-management. Until recently, a key advantage of traditional CGM over flash CGM was the availability of automatic alarms that warn users about current or impending hypoglycemia and hyperglycemia. However, with the introduction of the FreeStyle Libre 2 (FSL2) system (Abbott Diabetes Care, Alameda, CA), PwD can now utilize flash CGM with the option to set low and high glycemic thresholds and receive alarms when these thresholds are crossed. In addition, having the option to use or not use the alarms may attract previous traditional CGM users who grew fatigued by constant alarms. However, despite the additional layer of safety that alarms provide, many PwD are reluctant to switch from self-monitoring of blood glucose to CGM due to concerns about how alarms could impact the quality of their daily lives. This reluctance is heightened by their perceptions that use of alarms is mandatory. Because the functionality of the FSL2 alarms differs from current traditional CGM devices, it is important that clinicians become familiar with these differences. Moreover, clinicians will be challenged to help PwD overcome their concerns about the use of alarms. This article presents a comprehensive description of the FSL2 alarms function and provides guidance to clinicians when counseling PwDs about the strengths, limitations, and various ways that the FSL2 alarms can be used in daily diabetes self-management.

Evolving Use of Continuous Glucose Monitoring Beyond Intensive Insulin Treatment

Numerous studies have demonstrated the clinical benefits of continuous glucose monitoring (CGM) use in individuals with type 1 diabetes and type 2 diabetes (T2D) who are treated with intensive insulin therapy. A growing body of evidence suggests that CGM use may also confer similar glycemic benefits in T2D individuals who are treated with less-intensive therapies. Investigators are also exploring the potential use of CGM as an aid in weight management. This article reviews the continuing evolution of CGM, focusing on how CGM may be used to improve glycemic control and promote adoption of desired health behaviors within broader T2D and prediabetes populations.

Continuous Glucose Monitoring (CGM) Is a Tool, Not a Reward: Unjustified Insurance Coverage Criteria Limit Access to CGM

Recent studies have demonstrated the clinical utility of continuous glucose monitoring (CGM) use in type 2 diabetes (T2D) patients who are treated with intensive insulin management. Large retrospective database analyses of T2D patients treated with less-intensive therapies have also shown that CGM use was associated with significant reductions in hemoglobin A1c levels and health resource utilization, including diabetes-related hospitalizations and emergency room care. Despite the growing body of evidence supporting CGM use in the broader T2D population, current eligibility criteria required by public and many private insurers are denying millions of individuals with T2D access to this valuable technology. In this article, we discuss an evidence-based rationale for modifying current eligibility requirements for CGM coverage.

Integrating Continuous Glucose Monitoring Into Clinical Practices and Patients' Lives

Numerous studies have demonstrated the clinical benefits of continuous glucose monitoring (CGM) in individuals with diabetes. Within ongoing innovations in CGM technology, individuals now have an expanding array of options that allow them to select the device that meets their individual needs and preferences. Although demand for CGM in primary care continues to grow, many clinicians are reluctant to prescribe this technology due to their unfamiliarity with the various devices, uncertainty about which devices are best suited to each patient and the feasibility of using CGM. This article reviews the features and functionality of the most recent commercially available CGM devices and provides guidance for integrating CGM use into clinical practices.