Increased CGM Access Can Improve Treatment of T2D

This transcript has been edited for clarity.

I'm incredibly excited about the news that Medicare has increased access to continuous glucose monitoring (CGM) to many more of our patients. For a while, we've had access to CGM for our patients on insulin, but now we have access for people on noninsulin therapies who are also having hypoglycemia.

Let me review the new rules. First, anybody who takes insulin, no matter their type of diabetes and no matter how many injections, qualifies for CGM. In addition, people who aren't on insulin but are having episodes of hypoglycemia are also eligible for CGM. There's a number of qualifying features for those individuals.

First, anybody who's had an episode of severe hypoglycemia qualifies, so that's pretty easy and something we generally tend to document. The other criterion is harder. It requires that a person have two or more episodes of level 2 hypoglycemia, which means a glucose level of 54 mg/dL, and it also states that there has to be at least one, if not more, attempt to adjust their medication to prevent this from happening.

It's harder to document these level 2 hypoglycemia episodes because these people aren't on CGM and it requires they do fingersticks to prove their glucose levels are < 54 mg/dL. Most of my patients just treat an episode of hypoglycemia that's < 54 mg/dL rather than do a fingerstick.

We'll have to figure out how to document these episodes. Obviously, you don't want someone to have an episode of level 2 hypoglycemia to qualify for CGM. We'll have to be clear in our documentation and make sure we help our patients who need CGM get their CGM.

These benefits have already gone into effect. They started on April 17, 2023, and don't require an in-person visit to qualify. Telemedicine visits also help an individual qualify for these benefits.

Currently, the Medicare-approved CGM devices include the Libre 2 (Abbott Laboratories) and the Dexcom G6 or G7. I'm hoping that we could get approval of the Libre 3 as well because that's a nice device for our Medicare beneficiaries to have.

I couldn't be more excited about this new Medicare coverage because I think it will improve access for many more people who need CGM. CGM is an incredibly useful tool for patients because they can see what's happening in real time. They can see if they're going low, and they can see what happens when they exercise or eat certain foods.

I think it's a wonderful tool for patients, and I think it's incredibly helpful for providers because it lets us look at what's happening with our patients. It helps us adjust their medications, and I think it helps us encourage them to manage their diabetes.

This is a win-win and I'm very happy to be discussing this here today. Thank you.

Anne L. Peters, MD, is a professor of medicine at the University of Southern California (USC) Keck School of Medicine and director of the USC clinical diabetes programs. She has published more than 200 articles, reviews, and abstracts, and three books, on diabetes, and has been an investigator for more than 40 research studies. She has spoken internationally at over 400 programs and serves on many committees of several professional organizations.

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Increased CGM Access Can Improve Treatment for Those With T2D - Medscape - May 08, 2023.

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