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 
• 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 
• Provides information about what is happening with glucose levels overnight 
• Ability to adjust insulin dosing based on numbers and trend arrows 
• If integrated with an insulin pump, may be able to pause 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 
  

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 
• Allows for intensification in treatment program based on real-time glucose results 
• Reduction in hypoglycemia events 
• 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. 

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