Continuous Glucose Monitoring (CGM) Is a Tool, Not a Reward: Unjustified Insurance Coverage Criteria Limit Access to CGM

Diabetes Technol Ther. 2021 Sep;23(S3):S45-S55. doi: 10.1089/dia.2021.0193.

Abstract

Recent studies have demonstrated the clinical utility of continuous glucose monitoring (CGM) use in type 2 diabetes (T2D) patients who are treated with intensive insulin management. Large retrospective database analyses of T2D patients treated with less-intensive therapies have also shown that CGM use was associated with significant reductions in hemoglobin A1c levels and health resource utilization, including diabetes-related hospitalizations and emergency room care. Despite the growing body of evidence supporting CGM use in the broader T2D population, current eligibility criteria required by public and many private insurers are denying millions of individuals with T2D access to this valuable technology. In this article, we discuss an evidence-based rationale for modifying current eligibility requirements for CGM coverage.

Keywords: Blood glucose monitoring; Continuous Glucose Monitoring; Eligibility criteria; Type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring*
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Insurance Coverage
  • Retrospective Studies
  • Reward

Substances

  • Blood Glucose