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Review
. 2023 Oct;25(10):741-751.
doi: 10.1089/dia.2023.0268. Epub 2023 Aug 3.

Coverage for Continuous Glucose Monitoring for Individuals with Type 2 Diabetes Treated with Nonintensive Therapies: An Evidence-Based Approach to Policymaking

Grazia Aleppo  1 , Irl B Hirsch  2 , Christopher G Parkin  3 , Janet McGill  4 , Rodolfo Galindo  5 , Davida F Kruger  6 , Carol J Levy  7 , Gregory P Forlenza  8 , Guillermo E Umpierrez  9 , George Grunberger  10 , Richard M Bergenstal  11
Affiliations
Review

Coverage for Continuous Glucose Monitoring for Individuals with Type 2 Diabetes Treated with Nonintensive Therapies: An Evidence-Based Approach to Policymaking

Grazia Aleppo et al. Diabetes Technol Ther. 2023 Oct.

Abstract

Numerous studies have demonstrated the clinical benefits of continuous glucose monitoring (CGM) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) who are treated with intensive insulin regimens. Based on this evidence, CGM is now a standard of care for individuals within these diabetes populations and widely covered by commercial and public insurers. Moreover, recent clinical guidelines from the American Diabetes Association and American Association of Clinical Endocrinology now endorse CGM use in individuals treated with nonintensive insulin regimens. However, despite increasing evidence supporting CGM use for individuals treated with less-intensive insulin therapy or noninsulin medications, insurance coverage is limited or nonexistent. This narrative review reports key findings from recent randomized, observational, and retrospective studies investigating use of CGM in T2D individuals treated with basal insulin only and/or noninsulin therapies and presents an evidence-based rationale for expanding access to CGM within this population.

Keywords: Basal insulin; Continuous glucose monitoring; HbA1c; Noninsulin medications; Type 1 diabetes; Type 2 diabetes.

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Conflict of interest statement

G.A. has received research support to Northwestern University from Emmes, Fractyl Health, Insulet, Tandem Diabetes and WellDoc. G.A. has received consulting fees from Dexcom and Insulet outside of this work. C.G.P. has received consulting fees from Abbott Diabetes Care, CeQur, Dexcom, LifeScan, Mannkind, Roche Diabetes Care, and Provention bio. I.B.H. serves as an advisory board member for Abbott Diabetes Care, Roche, and Bigfoot, and GWave and receives research grant support from Dexcom. J.M. has received research support from the NIH, Helmsley foundation, JDRF, Novo Nordisk, and Beta Bionics. J.M. has received consulting fees from Bayer, Boehringer Ingelheim Lilly, Mannkind, Novo Nordisk and Thermo Fisher outside of this work. R.G. is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) under Award Numbers 2P30DK1110246 and K23DK123384-3.

R.G. received research support to Emory University for investigator-initiated studies from Novo Nordisk, Dexcom, and Eli Lilly and consulting fees from Sanofi, Eli Lilly, Boehringer, Pfizer, and Weight Watchers, outside of this work. G.A. has received research support to Northwestern University from AstraZeneca, Dexcom, Eli Lilly, Emmes, Fractyl Health, Insulet, Novo Nordisk, and WellDoc. D.F.K.'s institution has received research support from NIH, Helmsley Foundation, Novo Nordisk, Abbott Diabetes, and Dexcom; consulting fees from Novo Nordisk, Abbott Diabetes, Mannkind, CeQur, Sanofi, Medical Module, Provention bio, and Pendulum; speaker for Dexcom, Novo Nordisk, Sanofi-Aventis, Xeris, and CeQur; stock options not redeemed Pendulum. CJL has received research support from the NIDDK and Helmsley Foundation and industry support paid to the Icahn School of Medicine at Mount Sinai from Abbott Diabetes, Dexcom, Insulet, Novo Nordisk, Senseonics, and Tandem. C.J.L. has received consulting fees from Eli -Lilly and Dexcom outside of this work.

G.P.F. received research support from Medtronic, Dexcom, Abbott, Tandem, Insulet, Beta Bionics, and Lilly, and has served as a consultant, speaker, and advisory board member for Medtronic, Dexcom, Abbott, Tandem, Insulet, Beta Bionics, and Lilly. G.E.U. is partly supported by research grants from the National Institutes of Health (NIH/NATS UL 3UL1TR002378-05S2) from the Clinical and Translational Science Award program, and from National Institutes of Health and National Center for Research Resources (NIH/NIDDK 2P30DK111024-06). G.E.U. has received research support (to Emory University) from AstraZeneca, Bayer, Abbott, and Dexcom. G.G. reports receiving fees from Eli Lilly, Novo Nordisk (speakers' bureau), LifeScan, and Nevro (advisory boards).

R.M.B. has received research support, consulted, or has been on a scientific advisory board for Abbott Diabetes Care, Ascensia, CeQur Corporation, Dexcom, Hygieia, Insulet, Johnson & Johnson, Lilly, Medtronic, Novo Nordisk, Onduo, Roche, Sanofi, United Healthcare, and Zealand. His technology research is funded, in part, by NIH/NIDDK. R.M.B.'s employer, nonprofit HealthPartners Institute, contracts for his services and no personal income goes to R.M.B.

References

    1. Centers for Disease Control and Prevention. Prevalence of Both Diagnosed and Undiagnosed Diabetes. Available from: https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnose... [Last accessed: February 2, 2023].
    1. Fang M, Wang D, Coresh J, et al. . Trends in diabetes treatment and control in U.S. adults, 1999–2018. N Eng J Med 2021;384:2219–2228; doi: 10.1056/NEJMsa203227 - DOI - PMC - PubMed
    1. International Diabetes Federation. IDF Diabetes Atlas, 10th ed. Brussels, International Diabetes Federation, 2021. Available from: https://diabetesatlas.org/atlas/tenth-edition [Last accessed: January 31, 2023].
    1. World Health Organization. Fact Sheets: Diabetes. September 16, 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes [Last accessed: November 25, 2022].
    1. Basu S, Yudkin JS, Kehlenbrink S, et al. . Estimation of global insulin use for type 2 diabetes, 2018–30: A microsimulation analysis. Lancet Diabetes Endocrinol 2019;7(1):25–33. - PubMed

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