RT-CGM: A Key Tool for Primary Care

Provided by AAFP partner

Real-time continuous glucose monitoring (RT-CGM) is recognized as a standard of care in diabetes management for people with diabetes treated with one or more insulin doses.¹ Supported by clear evidence from well-conducted randomized controlled trials, RT-CGM use not only leads to significant reductions in A1C and more time in range^2-6 but also improves overall well-being and quality of life.^7,8

For the primary care clinician, CGM data serves as an essential tool for demystifying the complexity of diabetes and adjusting diabetes treatment plans. It also provides insights to better understand how diabetes impacts a person’s life and their lived experience when managing diabetes day to day. Diabetes is continuous, and although important treatment is provided during office visits, the majority of diabetes care happens outside of those clinical encounters.⁹

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For the person living with diabetes, RT-CGM can be a reliable tool for informed decisions to live a healthier, more confident life.¹⁰ In a survey of 40 current CGM users with any type of diabetes¹¹:

87% reported changing their food choices
42.5% felt more physically active after using CGM
90% reported CGM use contributed to a healthier lifestyle

Trend arrows show the person — in real time — where their glucose is heading so they can proactively manage their diabetes¹²and make in-the-moment decisions (for example, what to eat at a restaurant). Viewing one’s own retrospective data is shown to reduce diabetes distress and problems with hypoglycemia and chronic hyperglycemia.⁸ Information provided by RT-CGM gives power back to the person to choose what works best for them and eliminate some of the barriers to living a joy-filled and healthier life with diabetes.

RT-CGM is a key tool in supporting effective communication and a shared understanding between the person with diabetes and their primary care clinician. Watch this 9-minute video discussion between a family physician and a person with diabetes about their experiences with RT-CGM and their views on the value it brings to treating and living with diabetes.

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REFERENCES

ElSayed NA, et al. 7. Diabetes Technology: Standards of Care in Diabetes--2023. Diabetes Care. 2023;46(Suppl 1):S111-S127.
Beck RW, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults with Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. JAMA. 2017;317(4):371-378.
Beck RW, et al. Continuous Glucose Monitoring Versus Usual Care in Patients with Type 2 Diabetes Receiving Multiple Daily Insulin Injections: A Randomized Trial. Ann Intern Med. 2017;167(6):365-374.
Martens T, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial. JAMA. 2021;325(22):2262-2272.
Laffel LM, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Adolescents and Young Adults with Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2020;323(23):2388-2396.
Welsh JB, et al. Comparisons of Fifth-, Sixth-, and Seventh-Generation Continuous Glucose Monitoring Systems. J Diabetes Sci Technol. 2022:19322968221099879.
Gilbert TR, et al. Change in Hemoglobin A1C and Quality of Life with Real-Time Continuous Glucose Monitoring Use by People with Insulin-Treated Diabetes in the Landmark Study. Diabetes Technol Ther. 2021;23(Suppl 1):S35-S39.
Polonsky WH, et al. The Role of Retrospective Data Review in the Personal Use of Real-Time Continuous Glucose Monitoring: Perceived Impact on Quality of Life and Health Outcomes. Diabetes Technol Ther. 2022;24(7):492-501.
Corathers SD, et al. Therapeutic Inertia in Pediatric Diabetes: Challenges to and Strategies for Overcoming Acceptance of the Status Quo. Diabetes Spectr. 2020;33(1):22-30.
Crawford MA, et al. Exploring the Impact of CGM on Perceived Control of Non-Intensive Insulin Treated Type 2 Diabetes—“I liked keeping my line with as few spikes as possible.“ [Poster presentation 677-P]. American Diabetes Association Scientific Sessions, 2023, San Diego, CA.
Ehrhardt N, et al. Continuous Glucose Monitoring as a Behavior Modification Tool. Clin Diabetes. 2020;38(2):126-131.
Dexcom G7 User Guide. April 2023. Accessed June 12, 2023. https://dexcompdf.s3.us-west-2.amazonaws.com/en-us/G7-CGM-Users-Guide.pdf

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