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Review
. 2025 Jul;41(5):e70059.
doi: 10.1002/dmrr.70059.

Enhancing Type 2 Diabetes Care With CGM Integration: Insights From an Italian Expert Group

Concetta Irace  1 , Angelo Avogaro  2 , Federico Bertuzzi  3 , Raffaella Buzzetti  4 , Riccardo Candido  5 , Stefano Del Prato  6 , Paolo Di Bartolo  7 , Paolo Fiorina  8   9   10 , Carlo Bruno Giorda  11 , Francesco Giorgino  12
Affiliations
Review

Enhancing Type 2 Diabetes Care With CGM Integration: Insights From an Italian Expert Group

Concetta Irace et al. Diabetes Metab Res Rev. 2025 Jul.

Abstract

Type 2 diabetes (T2D) is a pandemic and strongly impact patients' prognosis. Several barriers may hamper the achievement of good glycaemic control, which is the aim of diabetes care. These include but are not limited to poor treatment adherence, poor self-management, and heterogeneity of the disease context. Diabetes self-management is critical, particularly in insulin-treated patients and it is largely based on glucose monitoring, which allows recording glucose levels to make informed decisions with respect to meals, exercise, and other daily-life activities. For decades, glucose monitoring has been based on self-measurement of capillary blood glucose, which has some obvious important limitations. With the start of the new century, systems for continuous glucose monitoring (CGM) have become available. These systems measure subcutaneous interstitial glucose levels in a continuous or intermittent manner. They allow a better description of daily glucose pattern and glycaemic trend, a more accurate identification of glucose peaks and identification of otherwise unrecognised hypoglycaemic episodes, and a more reliable assessment of the stability of glycaemic control. CGM has been repeatedly shown to improve glycaemic control and reduce the risk of hypoglycaemia in type 1 diabetes (T1D). Over the years however, evidence has been gathered on the CGM use in T2D on different treatment regimens and wider applications are clearly desired. The aim of this expert opinion paper is to summarise the currently available evidence on CGM use across the whole spectrum of T2D and suggest practical indications beyond current guidelines.

Keywords: basal insulin; clinical scenario; continuous glucose monitoring; cost‐effectiveness; drug therapy; multiple daily insulin injections; type 2 diabetes.

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Conflict of interest statement

CI has provided advisory board services for Novo Nordisk, Roche Diabetes Care Italy, Abbott, Menarini, Ascensia, and Senseonics and has received speaker fees from Novo Nordisk, Roche Diabetes Care Italy, Abbott, Ascensia, Lilly, and Boehringer Ingelheim Pharmaceuticals; FB received honoraria and speaker fees from Abbott, Medtronic, Theras, Movi, Lilly; SDP has served as president of EASD/European Foundation for the Study of Diabetes (EFSD) (2020–2022) and is the president of the Menarini Foundation; has received research grants to the institution from AstraZeneca and Boehringer Ingelheim; has served as advisor for Abbott, Amarin Corporation, Amplitude, Applied Therapeutics, AstraZeneca, Biomea Fusion, Eli Lilly & Co., EvaPharma, Menarini International, Novo Nordisk, Sanofi, and Sun Pharmaceuticals; and has received fees for speaking from AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co., Laboratori Guidotti, Menarini International, Merck Sharpe & Dohme, and Novo Nordisk; PDB received honoraria and speaker fees from Abbott, Medtronic, Theras, Eli Lilly, Novo Nordisk, Guidotti, Boehringer, Astra Zeneca, Ascensia Bayer, Allergan, Insulet; FG: Eli Lilly, Roche Diabetes Care (grants); Eli Lilly, Novo Nordisk (consulting fees); AstraZeneca, Boehringer‐Ingelheim, Eli Lilly, Lifescan, Merck Sharp & Dohme, Medtronic, Novo Nordisk, Roche Diabetes Care, Sanofi Aventis; Eli Lilly, Sanofi Aventis (support for attending meetings/travel); AstraZeneca, Boehringer‐Ingelheim, Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune, Medtronic, Novo Nordisk, Roche Diabetes Care, Sanofi Aventis (participation on Advisory Boards); EASD/EFSD, Società Italiana di Endocrinologia (SIE), Fo.Ri.SIE (unpaid leadership); AstraZeneca, Eli Lilly, Novo Nordisk, Sanofi Aventis (support for medical writing and statistical analysis); AA, RB, RC, SDP, PF, CBG have no competing interests to declare. The sponsor played no role in the design, execution, interpretation or writing of this manuscript.

Figures

FIGURE 1
FIGURE 1
Barriers in the control of type 2 diabetes.
FIGURE 2
FIGURE 2
How CGM can overcome the barriers to glycaemic control.
FIGURE 3
FIGURE 3
Expert suggestion on intermittent CGM use for T2D patients on oral antidiabetic drugs.
See this image and copyright information in PMC

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