CGM Clinical Practice Guidelines & Position Statements  

ADCES 2021 Practice Papers

Diabetes care and education specialists who are well versed in professional and personal CGM devices are in a key position to promote and support this option for people with Type 1 and Type 2 diabetes. The diabetes care and education specialist can help identify those who would benefit from professional or personal CGM, collaborate with their provider to facilitate obtaining an appropriate device, educate them on the utilization, and download the results to evaluate in order to maximize diabetes management outcomes.

Diabetes care and education specialists provide the coaching needed to help PWD reap the benefits of the technology by utilizing the information to make smarter diabetes management decisions, reduce risk of hypoglycemia and hyperglycemia and thereby improve quality of life. 

Read the Practice Paper, The Diabetes Care and Education Specialist’s Role in Continuous Glucose Monitoring.

Read the Practice Paper, Continuous Subcutaneous Insulin Infusion (CSII) Without and With Sensor Integration.

ADA 2020 CGMs

International Consensus on Use of Continuous Glucose Monitoring | Diabetes Care | American Diabetes Association (diabetesjournals.org) in conjunction with insulin therapy, are a useful tool to lower HbA1C levels and/or reduce hypoglycemia in adults with Type 1 diabetes (T1D) who are not meeting glycemic targets, have hypoglycemia unawareness and/or have episodes of hypoglycemia.

CGM should be considered in all children and adolescents with Type 1 diabetes, whether using injections or continuous subcutaneous insulin infusion, as an additional tool to help improve glucose control. CGMs in conjunction with insulin therapy are useful tools to lower A1C and/or reduce hypoglycemia in adults with Type 2 diabetes (T2D) who are not meeting glycemic targets. Real-time CGM may be used effectively to improve A1C levels, time in range and neonatal outcomes in pregnant women with Type 1 diabetes. Real-time CGM devices should be used as close to daily as possible for maximal benefit. Intermittently scanned CGM devices should be scanned frequently, at a minimum of once every 8 hours. Visit the ADA diabetes journals site.

Endocrine Society 2022

The 2022 guideline on management of individuals with diabetes at high risk for hypoglycemia Clinical Practice Guideline:

• Updates the 2009 Evaluation and Management of Adult Hypoglycemic Disorders
• Focuses on the treatment of individuals with diabetes at high risk for hypoglycemia.
• Emphasizes the use of emerging diabetes technology and insulin therapy for glycemic management and education.

AACE/ACE 2020

CGM is preferred over SMBG. Use of personal CGM devices (i.e., those owned by the patient) should be considered for those patients who are on intensive insulin therapy (3 to 4 injections/day or on insulin pump), for those with history of hypoglycemia unawareness, or those with recurrent hypoglycemia. While these devices could be used intermittently in those who appear stable on their therapy, most patients meeting these criteria will need to use this technology on a continual basis. 

As experience with CGM in T2D grows, we anticipate more frequent use of both professional and personal devices, which may increasingly replace SMBG. 

AACE guideline The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus includes evidence-based clinical practice recommendations for advanced diabetes technology including Continuous Glucose Monitors.

International Consensus 2017

CGM should be considered in conjunction with HbA1C monitoring for glycemic status assessment and therapy adjustment for all patients with Type 1 diabetes and patients with Type 2 diabetes treated with intensive insulin therapy who are not achieving glucose targets, especially if the patient is experiencing problematic hypoglycemia. See update in 2019 here for further details about glycemic goals and use of AGP data: Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Visit the ADA diabetes journals site.