From the Guidelines
Continuous glucose monitoring (CGM) is indicated for patients with type 2 diabetes who use multiple daily insulin injections or insulin pump therapy, those with history of problematic hypoglycemia, and individuals with highly variable blood glucose levels despite optimized insulin therapy. The evidence from recent studies, such as the one published in 2023 1, suggests that CGM can be beneficial for patients with type 2 diabetes, particularly those on intensive insulin regimens or with problematic glucose control.
Some key benefits of CGM for patients with type 2 diabetes include:
- Improved glycemic control and reduced hypoglycemia risk
- Enhanced patient education and awareness of glucose trends and patterns
- Timely interventions and insulin dose adjustments
- Better understanding of how food, physical activity, and medications affect glucose levels
The guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus, published in 2023 1, also support the use of CGM in patients with type 2 diabetes who are using insulin and not meeting glycemic targets. Additionally, the Chinese clinical guidelines for continuous glucose monitoring, published in 2019 1, recommend CGM for type 2 diabetes patients who need intensive insulin therapy or have unexplainable severe hypoglycemia or recurrent hypoglycemia.
It's worth noting that the evidence for CGM use in type 2 diabetes is growing, and recent studies, such as the one published in 2022 1, have shown benefits of intermittent use of CGM in individuals with type 2 diabetes on noninsulin and/or basal insulin therapies. Overall, CGM is a valuable tool for patients with type 2 diabetes, particularly those with problematic glucose control or hypoglycemia risk, and can help improve glycemic outcomes and quality of life.
From the Research
Evidence-Based Indications for Continuous Glucose Monitoring in Type 2 Diabetes
- The use of continuous glucose monitoring (CGM) in patients with type 2 diabetes has been studied in various contexts, including its impact on hypoglycemia and glycemic variability 2, reduction of diabetes-related hospitalizations 3, and clinical use in adults with type 2 diabetes 4.
- Studies have shown that CGM can be beneficial for adults with type 2 diabetes using intensive insulin therapy 5, and its use in type 2 diabetes treated with basal insulin without prandial insulin has also been explored 5.
- The indications for using CGM in type 2 diabetes are evolving, and it may be useful in various situations, including:
- Newly diagnosed patients where treatment is being started
- Uncontrolled diabetes where treatment is being altered
- Starting intensive lifestyle modification
- During infections
- During preoperative control
- In children and adolescents with type 2 diabetes
- As a motivational tool to improve behavioral modification
- After metabolic surgery
- In patients on steroids 6
- CGM has been shown to reduce hypoglycemic events and time spent in the hypoglycemic range 2, and decrease rates of hospitalizations for hyperglycemia or hypoglycemia 3.
- The use of CGM on an intermittent basis, defined as the use of CGM once in 2 or 3 months or a fixed frequency, may be useful in several situations in those with type 2 diabetes 6.