Continuous Glucose Monitoring

Helping patients better understand how food & exercise choices impact blood glucose

See our collection of CGM resources for patients and providers
 Are you a CGM user with type 2 diabetes? Consider sharing your anonymized data with MCT2D
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If you use a Dexcom CGM, complete this quick form to get started.
If you use a FreeStyle Libre CGM, under your connected practices, enter the practice ID: MCT2DCGMClick “Learn More” on the left, for step by step instructions.

BACKGROUND

The first ever continuous glucose monitor (CGM) was approved by the FDA in 1999. Since that time, the primary utilization of CGMs has been to provide real-time awareness of hypoglycemic events to patients with type 1 diabetes. Since its initial approval, CGM technology has advanced rapidly and so to, it’s breadth of therapeutic relevance. Recent clinical trials have demonstrated clear and concise evidence that CGMs are an effective tool for individuals with type 2 diabetes (T2D). Individuals with T2D benefit from CGM in two main capacities, medication optimization and diet modification.

WHAT IS A CGM?

CGMs consist of a subcutaneous sensor that measures interstitial glucose, a transmitter to send the information, and a monitoring device to receive and display that information to the patient and their healthcare provider. To use a CGM, a patient inserts a small, flexible sensor into their arm or abdomen, where it remains for 10-14 days. A transmitter connected to the sensor permits the CGM device to send close-to real-time readings to a monitor device that will display a patient’s blood glucose data - this can be an app on a patient’s phone or a separate monitoring device.
Hear from Bob, who has Type 2 Diabetes:
“I had a CGM. it made it easier to be more accountable. I had more of a goal, to see that number, to try to keep it down.”

HOW CGMS CAN IMPROVE T2 DIABETES CARE

Finger poke blood sugar testing provides only a snapshot in time, rather than a comprehensive view of a person’s glucose over the course of an entire day. For example, imagine a patient with a relatively good HbA1c of 6.5% who checks their sugar by pricking their fingers twice a day, once in the morning, and once before bed. Both of these readings are usually in the 120-150 range. Between these readings and their A1c result, the patient’s provider does not recommend any changes to diet and medications. However, what this does not show is that this individual is experiencing high glucose levels of 200-250 after meals, and low glucose values of 58-70 during the night, resulting in their average A1c of 6.5%. By utilizing a CGM, this individual and their provider are able to address both medication optimization and diet modification. After wearing a CGM for 14 days, the patient and provider see these peaks and valleys and the provider suggests that the patient start a low carbohydrate diet to reduce their high glucose peaks after meals, as well as reduce their nighttime basal insulin by 20% to prevent their lows. After a few weeks, the patient wears another CGM sensor and they see that their post meal glucose values are now between 130-160, and that they are no longer having lows at night. This example helps demonstrate the very real benefit that CGM has for patients with type 2 diabetes.
See the evidence

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Blue Cross Blue Shield Blue Care Network of Michigan

Support for the Michigan Collaborative on Type 2 Diabetes is provided by Blue Cross Blue Shield of Michigan and Blue Care Network as part of the BCBSM Value Partnerships program. BCBSM’s Value Partnerships program provides clinical and executive support for all CQI programs. To learn more about Value Partnerships, visit www.valuepartnerships.com. Although Blue Cross Blue Shield of Michigan and the Michigan Collaborative on Type 2 Diabetes work in partnership, the opinions, beliefs, and viewpoints expressed by MCT2D do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees.