I was honored last year to be asked to write an article about the basics of continuous glucose monitoring (CGM) for primary care providers by the BMJ, which was released today online.
This, like most of my academic literature article writing, was an unpaid gig. So why did I do it?
Well, most people with diabetes are treated primarily by primary care providers (“GPs” or “PCPs” or “family doctors”, etc). It’s somewhat rare for most people with diabetes to see an endocrinologist! It also varies regionally, even within the same country. And, primary care providers obviously treat a lot of widely varying conditions, from acute to chronic, so they may not have time or energy to stay up to date on all treatment options for all conditions.
This therefore felt like a great opportunity to contribute some information about CGM, an incredibly useful piece of technology for anyone with diabetes who wants it, specifically written and targeted for primary care providers who may not have the exposure to CGM technology that endocrinology providers have had over the years. And, like most things, the technology (thankfully) has changed quite a bit. Accuracy, ease of use, cost, and many other factors have changed dramatically in the last almost two decades since CGMs were introduced on the market!
I sought out two fellow experts in CGM and diabetes technology to co-author the article with me. I asked Ben Wheeler, an excellent pediatric endocrinologist who has done quite a bit of research on “intermittently scanned” CGMs (isCGM); and Tamara Oser, who is the director of the Primary Care Diabetes Lab (and a parent and a spouse of people living with diabetes) and worked to facilitate uptake of CGM in primary care settings.
I’m also appreciative that a parent and teen with newly diagnosed diabetes and new experiences with CGM both reviewed this article when it was drafted and shared their perspective to it; as well as appreciative of valuable input from a friend with many years of experience with diabetes who has used 8 (!) different CGM systems.
We are starting to see a shift in adoption and coverage of CGM, thankfully. Historically, people with diabetes haven’t always had insurance cover CGM. Even if insurance does cover CGM, sometimes we have to fight an uphill battle every year to re-prove that we (still) have diabetes and that we still need CGM. Sometimes good outcomes from using CGM disqualifies us from the next year’s coverage of CGM (in which case we have to appeal our cases for coverage). It’s frustrating! That’s why it’s so nice to see increasing guidelines, recommendations, and even country-specific guidelines encouraging funding and coverage of CGM for people with all types of diabetes. The biggest latest news – as of yesterday (March 2, 2023) – was that in the U.S., Medicare will now be covering CGM for people with type 2 diabetes on insulin. This is a huge group of people who previously didn’t have CGM coverage before!
So here it is, just out today online (March 3, 2023), and projected to be in the March 25, 2023 print edition of the BMJ: an article on continuous glucose monitoring (CGM) for primary providers. I’m hoping it helps pave the way for more providers to feel comfortable prescribing CGM for more people with diabetes; increased their knowledge in working with people with diabetes who have CGM prescribed from other providers; and also reduce unconscious and conscious bias against people with diabetes being offered this important, life-changing and life-saving technology.
P.S. – if you can’t access the article from the link above, as a reminder I always store an accessible author copy of my research articles at DIYPS.org/research!