Continuous Glucose Monitoring (CGM) Marches On
Two significant developments in the field of continuous glucose monitoring (CGM) took place recently.
First, CMS (Center for Medicare and Medicaid Services) finally and belatedly agreed on April 16, 2023 to cover CGM devices for all people insured by these government programs on ANY insulin therapy. That expansion alone opens the possibility for the benefits of CGM for millions of those patients and not only for those on intensive insulin regimens (i.e. at least 3 insulin injections a day or an insulin pump).
In addition, CMS coverage for CGM ALSO applies to those NOT on insulin but having “recurrent” (at least 2) documented episodes of level 2 hypoglycemia (glucose under 54 mg/dl) or a level 3 (severe, in which someone’s assistance was necessary) which opens the possibility of coverage to those on sulfonylurea oral medications.
The second positive development was the April 14, 2023, FDA approval of a receiver (“reader”) for the Abbott’s Freestyle Libre 3 system. This is unlike the original Libre, the 14-day version, and the Libre 2 system readers, which were introduced along with the later approval of smartphone apps. For Libre 3 the company presumably felt that everyone owns or wants to use a smartphone. It turns out they guessed wrong. Even in 2023, there are a lot of people who either don’t own or want to use smartphones to track their sugar levels. This choice now expands the ranks of CGM users. The Libre 3 reader, just like the app, does not require any manual scanning by the patient; it automatically transmits the glucose values continuously, updating them every minute.
