Weighing CGM Pros and Cons

Presenting a full picture of this technology helps the user make smart decisions

Continuous Glucose Monitors, like all technology options, have advantages and disadvantages. When working with a person with diabetes, presenting a full picture of a technology allows for them to make an informed decision. Below is a list of advantages and disadvantages of using CGM to help manage diabetes that need to be presented for consideration in a shared decision-making environment.

For the person living with diabetes

Potential ADVANTAGES:

• Shows a more accurate picture of glucose levels through the day and overnight
• Shows current glucose level and predicts direction that glucose is heading and rate of change 
• Allows patient to assess glycemic patterns and glycemic variability 
• Can potentially prevent hypoglycemia and hyperglycemia 
• Provides alerts when glucose level is too low or too high 
• Shows how lifestyle choices and other factors affect glucose 
• Ability to share glucose levels with a family member and/or healthcare team 
• Ability to adjust insulin dosing based on numbers and trend arrows 
• When integrated with an insulin pump, able to pause and/or adjust insulin delivery in response to changes in glucose levels

Potential DISADVANTAGES:

• Cost, especially if not covered by insurance 
• Insurance coverage or qualifications for coverage may be an issue 
• May require calibration with fingerstick glucose 
• Need to remember to scan an intermittently-scanned device 
• Can be complicated to learn, up front learning curve 
• Information overload 
• Alarm fatigue – the condition in which device users are repeatedly bothered by frequent and/or false alarms 
• Constant presence of sensor on/in the body 
• Skin irritation, allergic reactions, and adhesion issues  
  

There are also many benefits to the healthcare team of the person living with diabetes: 

• Offers detailed glucose metrics including time in range, time above/below range, and glycemic variability 
• Shows 24-hour-a-day glucose values, including times when the patient may not have checked, such as while sleeping, post-prandial, etc. 
• Data can be viewed remotely which allows for therapy changes between traditional clinic visits and allow for Remote Patient Monitoring (RPM)
• Allows for intensification in treatment program based on real-time glucose results 
• Visualization of glucose data can enable providers to educate individuals to understand and avoid hypoglycemia
• Potentially avoid hospitalizations via reduction in extremes of glucose levels 
• Potentially decrease long-term complications of diabetes via improved glucose control

A Continuous Glucose Monitor is a useful tool to help manage diabetes in the hands of someone who wants to use it. Educating a person with diabetes about a CGM allows them to become familiar with it as an option to help them improve their diabetes management throughout their diabetes journey.  Sharing the advantages and disadvantages allows for informed conversations and educated decisions at every step of the way which leads to improved outcomes. 

Frequently Asked Questions:

• CGM provides continuous, real-time glucose data, eliminating the need for frequent fingerstick checks. It enhances hypoglycemia prevention, improves glycemic control, and allows for proactive treatment decisions.

• Yes! The ADA 2025 Standard of Care now supports CGM for Type 2 diabetes on insulin and other glucose lowering agents.

• CGM alerts notify users of rapid glucose changes, hypoglycemia, and hyperglycemia, allowing for early intervention. Customizing alerts helps prevent alarm fatigue while maintaining patient safety.

• The ADA SOC 2025 recommends CGM for all individuals with Type 1 diabetes and those with Type 2 diabetes on insulin. It is also strongly recommended for pregnant individuals, older adults at risk for hypoglycemia, and children from the time of diagnosis.

• Yes, CGM sensors that are integrated with AID systems, automatically adjusting insulin delivery based on glucose readings. This can potentially reduce glycemic variability and improve overall diabetes management.

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