Continuous Glucose Monitors

CGMs continually monitor your blood glucose (blood sugar), giving you real-time updates through a device that is attached to your body. They have become popular and more accurate over the years and are now considered a viable treatment option for people with diabetes.

Advances in CGM technology have made our lives easier, and that goes for people with diabetes as well. Insulin administration and blood glucose monitoring have transformed from multiple finger pricks in a day to a few swipes on a cell phone. With a CGM, one can see in real time if they’re trending high or low and take preventative measures against hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose). Real-time continuous glucose monitoring has led to tremendous outcomes for people with diabetes who, without a CGM, may have experienced potentially life-threatening complications. 

With the benefits and ease of use that a CGM provides, it would be natural to assume everyone with diabetes has one, or at least has access to one. That, however, is not the case. Studies show that poorer, older Black and Brown Americans and Americans on Medicaid have less access to CGMs than their counterparts. This is a health disparity we can’t ignore. People with diabetes have the right to access the latest technologies. Federal and state government officials can and should take steps to drive improved and more uniform coverage policies for diabetes technology and supplies within.

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CGMs provide significant, potentially life-changing benefits for diabetes management. CGMs are recommended for several reasons because they:

• Help avoid or delay serious, short- and long-term diabetes complications.
• Potentially save money through improved diabetes management and fewer events, like hypoglycemia leading to emergencies.
• Offer people with diabetes and their health care team more details about glucose levels than traditional blood glucose meters—giving the opportunity to analyze the data more precisely than ever before.
• Provide biofeedback in real time, which allows people with diabetes to modify their dietary pattern or insulin dose based on trends, as directed by their health care professional. This may reduce your risk of hypoglycemia and hyperglycemia.

People with type 1 and type 2 diabetes who use a CGM have fewer instances of hypoglycemia and a lower A1C.

Obstacles to Accessing CGMs

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One obstacle with CGMs is the cost of access to diabetes technology. Many people with diabetes who have put off getting an insulin pump or CGM, do so because they are too expensive.  

Another major obstacle is due to strict Medicaid coverage policies they are not accessible for people who need them. In fact, people with diabetes on Medicaid, especially in minority communities who use Medicaid, are the least likely to use a CGM. 

This is concerning since people with diabetes are more than twice as likely to receive their health care from Medicaid as those without diabetes.

Individuals who meet the coverage criteria listed in the FAQs below for a CGM and want to learn more about them should talk to their health care professional to ensure it is the right tool for the management of their diabetes.

The American Diabetes Association (ADA) released a new study looking at pharmacy and medical benefit claims for CGMs across commercial insurance plans, Medicare and Medicaid, and data on age, race, geography, and diabetes prevalence. The findings show people with lower incomes and older people of color who live in states with the highest rates of diabetes prevalence and mortality are the least likely to get access to a CGM. The ADA is quite concerned about these findings, given the effect of the COVID-19 pandemic on this population and the importance of tools like CGMs in diabetes management.

View the Study (PDF)