CGM is an incredible tool for people with any kind of diabetes. It can help lower A1C, decrease the risk of diabetes-related complications, and so much more. It’s becoming a game-changer for type 2 diabetes management. The ADA Standards of Care state that that in addition to those on insulin, CGM should be considered in adults with type 2 diabetes treated with glucose-lowering medications—and should be introduced as early as possible in people with diabetes, even at diagnosis. The evidence of CGM benefits in people with type 2 diabetes not using insulin are increasing and have shown greater benefits compared to a blood glucose meter for A1C, TIR, time below range, and time above range (TAR), as well as greater user-reported satisfaction.
Managing type 2 diabetes is a lot of work. It takes a team to be successful, and no matter who your team is, the person with diabetes is ultimately the one spending the most time managing their diabetes.The good news is that there are all kinds of tools that can help you help people with type 2 diabetes feel more excited, empowered, and confident in their self-management.
A commonly used tool is a continuous glucose monitor (CGM). These devices allow a person to see their glucose continuously while they wear them. This might sound daunting for some; it might be the last thing they want to know. But it’s helpful to always assure the wearer they will always be in control of how often they need to engage in their CGM data. It can also be helpful to highlight the benefits of wearing a CGM, like lowering A1C, reducing risk of long-term complications, and improving quality of life.
Wearing a CGM is not painful, and it can really help to make sense of how someone’s life activities affect their glucose. Most importantly, the use of CGM in people with type 2 diabetes can improve the safety of treatments. People often see an improvement in time in range, have a reduction in hypoglycemia, and can understand their glucose levels on a deeper level. This recent study found that CGM data provided actionable information that helped clinicians assign individualized treatment plans and enhanced understanding of glucose patterns.
One of the more challenging aspects of diabetes is not knowing what makes their glucose go up or down (there are 42 factors that can affect it!). It can be really frustrating to feel like you’re surprised by a glucose reading that does not make sense based on the way you feel or what you were doing at the time. When someone fingersticks (uses a blood glucose monitor), they can only see their current reading, but won’t really know what happened prior or where their glucose is going. It’s a single picture in time that may not fully explain how they got there. Using CGM can unveil those invisible patterns by showing the glucose trend over time.
Typically, CGM is covered by insurance for people with type 1 diabetes and people with type 2 diabetes who take insulin, mostly because CGMs can reduce the risk of hypoglycemia. Recent studies have shown that CGM use also improves glucose levels for people with type 2 diabetes who are not taking insulin. If someone in your care takes insulin, and you think they could be a good candidate for CGM, you can have a conversation with them about what it might look like. You can get information about your choices for CGMs at Diabeteswise.org, or even by keeping this downloadable poster in your office. This helps people with diabetes become familiar with the available CGMs, compare them, and provides them with other users’ experiences.
CGMs can help people with type 2 diabetes feel like they have a better sense of what is going on with their diabetes, and feel more in control. For example, someone might not know that having cereal or a slice of pizza (which have more “long-lasting carbs”) could make their glucose go higher than something like a Gatorade or a soda (which have more “fast-acting” carbs). When they’re equipped with that knowledge, they can make informed decisions that make them feel good.
Individualized care is essential when thinking about prescribing CGM. Some people will find that it might be overwhelming to see their glucose all of the time. Others might find that if their glucose is running high much of the time, the alarms will bother them. The good news is this is a tool people can choose to use—sometimes or regularly based on how it helps them. They are in the driver’s seat. Some people wear CGMs when changes are made in the treatment regimen, while other people use them to manage daily activities and diabetes. There are also many tips and tricks to make wearing a CGM a little easier.
Many people are excited that they need to use fingerstick glucose monitoring a lot less when they wear a CGM. That being said, you will want to encourage them to keep glucose testing supplies in case a CGM falls off, or if they get readings on the CGM that do not match how they feel.
You are in a unique position to help people with diabetes thrive in ways that weren’t possible just a few years ago. To learn more about CGM, including free resources for your practice, check out our free toolkit here!