Continuous glucose monitors (CGMs) have limited government coverage for people with diabetes across the spectrum – that needs to change!
CGMs have been a game changer for managing type-1 diabetes. But did you know that they could also be a game changer for managing type-2 diabetes as well.
It makes sense, doesn’t it.
The benefits of CGM for diabetes care in T1D
As people with type-1, let’s consider how continuous glucose monitors have changed our management practices:
We now have continuous, 24-hour data of what our blood sugars are doing. We know if they’re going low overnight, and we know if they’re trending up or down, and generally if they’re going up or down fast. Which means:
We. Can. Take. Action.
We can reduce insulin ahead of time based on blood sugar patterns.
We can eat smaller amounts of simple sugars when blood sugars are decreasing to prevent or reduce a low.
We can give appropriate correction doses.
We can plan for exercise a whole lot easier.
The list goes on and on.
The benefits of CGM for diabetes care in T1D and T2D
But let’s consider some non-insulin and non-hypoglycemic factors that continuous glucose monitors also benefit.
When we have all this data at our fingertips, for many of us, it can be a motivator.
I’ll use myself as an example:
If my blood sugars are trending up after a meal (or any other time for that matter), nine times out of 10, I’m putting my shoes on and going for a brisk 15-30 minute walk to bring them down. I’m maybe also considering, what did I eat in that meal, could it have contributed to the blood sugar rise? If so, what might I do differently? It’s unlikely that I’ll stop eating that food, because, well, that’s just not my style. But, I may adjust my insulin doses, or my portion sizes, or I might add some more vegetables or other fibre source, to offset the spike, or add some activity.
And if it’s not food related, I might consider other things in my life, such as my current stress levels, sleep patterns, if I’m coming down with a cold or flu, or menstrual cycle. And from there, I might make some other lifestyle changes.
There are a lot of things that we can adjust based on our CGM results. And a lot of these things are things that people with type-2 diabetes (with or without insulin) can also benefit from.
So why are we not sharing this wealth with that population?
CGMs are a great motivator for all sorts of diabetes management, whether it’s food related, activity related, or reducing stress related!
Lacking coverage for CGMs in Canada across the provinces
In British Columbia, where I work and reside, CGM coverage through provincial funding is only offered to people on multiple daily injections or on insulin pumps. A special authority is required to be completed by a doctor, and in addition to insulin therapy, the special authority also requires that the person requesting needs to have one of the following:
- Hypoglycemia unawareness
- Frequent and unpredictable hypoglycemic episodes
- Unpredictable swings in blood glucose
- At least one functional restriction that inhibits the use of blood glucose test strips
- An occupation where hypoglycemia presents a significant safety risk
First of all, I think that list is ridiculous for the type-1 diabetes population. The fact that extensive research shows that CGM coverage benefits T1D regardless of the above should be enough. We should not have to fight or negotiate or apply for something that is an obvious benefit.
Second, as much as I love my T1D population, I actually truly believe that the T2Ds are getting the shaft with this policy.
Blood glucose monitors are only checking one moment of blood sugars. They are not telling us what’s happening in 5-10-15 minutes from now. When we’re sleeping, most people are not setting multiple alarms through the night to check on what’s going on blood sugar wise. With glucometers, we are often making guesses, which can be so challenging. And there is not much there to motivate us to be the best we can be with our diabetes.
So, here we are, another shout out to our governments. Please, please start being more proactive. The more proactive we are in diabetes care, and healthcare as a whole, the better off the majority of our populations will be.
Isn’t that the ultimate goal?
Here is a link to updated provincial coverage of CGMs across Canada: https://www.diabetes.ca/getmedia/0170dc2c-0efe-4543-97b9-7b4563bb845f/Glucose_Monitoring_Devices_EN_2024.pdf