Author: Tom Sager
The article explores how expanding access to continuous glucose monitoring (CGM) for individuals with type 2 diabetes—especially those not using insulin—can lead to improved clinical outcomes and reduced healthcare costs. It presents peer-led best practices and underscores the value of integrating CGM into primary care, supported by real-world evidence. It highlights some of the latest evidence highlighting CGM’s benefits in lowering emergency department visits and optimizing medication use, while advocating for broader coverage and streamlined access to diabetes technology.
LEARN MOREDexcom G7 was associated with significantly improved A1c at 3 and 6 months, reduced body weight and BMI at 3 months, and improved TIR, TAR, and mean glucose at months 2 through 6 (p<0.05). This evidence supports updated standards of care that recommend consideration of CGM use in people with T2D not on insulin.
Learn MoreDexcom CGM is associated with a 14% reduction in the rate of CKD progression among adults with CKD using insulin over 3 years. At 3 years, 24.8% of Dexcom CGM users experienced CKD progression vs. 34.8% of CGM non-users. This study highlights the benefits of Dexcom CGM in reducing kidney disease progression in alignment with recent expert consensus statements supporting CGM use in individuals with CKD.
Learn MoreIn a large national federal cohort, initiation of CGM was associated with lower mortality in patients with type 2 diabetes (T2D) using insulin. Risk for mortality was lower in CGM users, as were risks for all-cause hospitalization, cardiovascular events, and admissions for hyperglycemia. These findings suggest that CGM may offer benefits beyond glycemic control, even for patients with T2D receiving less intensive treatment.
Learn MoreThis program explores how Continuous Glucose Monitoring (CGM) technology addresses therapeutic inertia, enhances glycemic control, and its role in quality metrics. Panelists examine the evidence to support expanding CGM access to broader diabetes populations in alignment with the 2025 ADA Standards of Care. The program will focus on overcoming barriers to CGM adoption and improving access in diverse patient populations by addressing racial and ethnic disparities. Additionally, this program will evaluate CGM’s impact on reducing healthcare resource utilization and cost management strategies to improve patient outcomes.
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This article addresses significant disparities in diabetes care within the United States, focusing on the underdiagnosis, undertreatment, and worse health outcomes experienced by minority populations, particularly Black and Hispanic individuals. It highlights the underutilization of Continuous Glucose Monitors (CGMs), a technology proven to improve diabetes management, despite clinical and economic benefits. The authors identify barriers to equitable access to CGMs, including high costs, insurance coverage limitations, and provider-level biases that result in less frequent discussions of this technology with minority patients. Finally, the writers propose policy changes by both private and public insurers and the increased promotion of patient education programs as crucial steps to reduce these disparities and enhance diabetes care for all.
Click here to watch the accompanying videos.
Expert: Juan Espinoza , MD, Chief Research Informatics Officer, Ann & Robert H. Lurie Children’s Hospital of Chicago NCQA Panel Committee Member, Diabetes Digital Technologies Roundtable participant (NCQA and ADA), NCQA Health Innovation Summit presenter
Summary: As CGM technology has revolutionized diabetes management, NCQA has recognized a need for more sophisticated measures to assess diabetes care quality. Since integrating the glucose management indicator (GMI) into their HEDIS measure set for 2024, NCQA and other key opinion leaders are looking at integrating further sophisticated metrics from CGM in the future. In this expert interview, Dr. Juan Espinoza shares key insights around the latest considerations on quality improvement in diabetes care relative to CGM-exclusive metrics. Having conducted years of research in the diabetes technology and quality space, Dr. Espinoza discusses evolving quality measures and their potential to advance diabetes management by incorporating a more comprehensive approach. In addition, he provides an overview of the value realized by payers and providers from integration of CGM data directly into the electronic health record.
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents - CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
CGM has advanced diabetes management, with demonstrated improvements in glycemic management, reduction of hypoglycemia-related resource utilization, and enhanced member engagement and self-management. While this technology was initially prescribed predominantly for those living with type 1 diabetes (T1D), the mounting body of evidence and expert recommendations have led to more widespread use in insulin-treated T2D, necessitating the implementation of evidence-based benefit design policies by health plans. During this working group meeting, leading payer and managed care decision makers reviewed recent findings and shared their insights on best practices for CGM coverage and reimbursement, including alignment with clinical practice guidelines, availability under the pharmacy benefit, and automated adjudication at the point of sale.
 Jim Kenney, RPh, MBA (Moderator)Founder and President JTKenney, LLC | Clinical Pharmacist, Healthcare and Family Services Bureau of Professional and Ancillary Services University of Illinois at Chicago |
 Thomas Grace, MDMedical Director Blanchard Valley Diabetes Center |  Estay Greene, PharmD, MBAVice President of Pharmacy Zing Health |
 Eric Long, PharmD, MBADisease Management Pharmacist Beacon Health System |  Scott McClelland, PharmDVice President, Commercial and Specialty Pharmacy Programs Florida Blue |
 Josh Moore, PharmDDirector of Pharmacy MO HealthNet Division Missouri Department of Social Services |  Diane E. Morgan, PharmDDirector, Specialty Pharmacy Government Programs Pharmacy UnitedHealthcare  |
 Heather Mullins, PMPSenior Clinical Program Manager UnitedHealthcare |  Susan Wescott, RPh, MBAExecutive Lead, Clinical Services, Alluma, LLC Senior Director of Pharmacy, Managed Care, Mayo Clinic |
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.