American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

June 2, 2021
CGM Technology and Digital Health
Guidelines / Policy

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

Source: Endocrine Practice

The American Association of Clinical Endocrinology (AACE) with a task force of medical experts developed evidence-based guideline recommendations regarding the use of advanced diabetes technology in clinical settings. The guidelines reveal that ensuring universal access to advanced diabetes technologies is anticipated to result in improved glycemia and allowing more persons with diabetes to achieve glycemic targets, improve quality of life, and potentially reduce burden of care. Furthermore, diabetes technology can improve the efficiency and effectiveness of clinical decision-making.

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  • CGM is strongly recommended for all persons with diabetes treated with intensive insulin therapy, defined as 3 or more injections of insulin per day or an insulin pump1
  • CGM is recommended for:
    • All individuals with problematic hypoglycemia (frequent/severe hypoglycemia, nocturnal hypoglycemia, hypoglycemia unawareness).2
    • Children/adolescents with T1D.2
    • Pregnant women with T1D and T2D treated with intensive insulin therapy.2
    • Women with gestational diabetes mellitus (GDM) on insulin therapy.3
  • CGM may be recommended for:
    • Women with GDM who are not on insulin therapy.3
    • Individuals with T2D who are treated with less intensive insulin therapy.4
Real-time CGM should be recommended over intermittently scanned CGM for:isCGM should be considered for:
  • persons with diabetes with problematic hypoglycemia (frequent/severe hypoglycemia, nocturnal hypoglycemia, hypoglycemia unawareness) who require predictive alarms/alerts; however the lifestyle of persons with diabetes and other factors should also be considered5
  • persons with diabetes who meet 1 or more of the following criteria6
    • Newly diagnosed with T2D
    • Treated with nonhypoglycemic therapies
    • Motivated to scan device several times per day
    • At low risk for hypoglycemia, but desire more data than SMBG provides

1Grade A; High Strength of Evidence; BEL 1; 2Grade A; Intermediate-High Strength of Evidence; BEL 1; 3Grade A; Intermediate Strength of Evidence; BEL 1; 4Grade B; Intermediate Strength of Evidence, BEL 1; 5Grade B; Low-Intermediate Strength of evidence; BEL; 6Grade D; Low Strength of Evidence/Expert Opinion of Task Force; BEL 

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