CGMs—Savvy Tech for Diabetes Management But Underutilized

Apparently, continuous glucose monitors (CGMs) are not as sweet as they seem.

Although CGMs are touted as an effective diabetes management tool, the devices’ overall adoption rate is rather low (6.3% of the 34 million Americans with diabetes) due to several challenges, according to an in-depth blog by Smart Meter, a supplier of Cellular Remote Patient Monitoring (RPM) solutions.
 
The top challenge is cost. A CGM’s initial setup can be as much as $1,200, and ongoing fees can total $300 a month. Such expenses can be a large barrier to many people with diabetes who cannot afford that kind of out-of-pocket expense. 
 
“While CGMs have been widely commercialized, they are simply not attainable for a large number of people with diabetes,” Smart Meter CEO Casey Pittock said. “In addition, the enormous amount of publicity that weight-loss drugs have received has complicated the CGM market, slowing demand. These two factors are leading more and more physicians to prescribe glucose monitors that use a small drop of blood to measure the patient’s current glucose level.”
 
Another major problem with CGMs is disconnection issues because they rely on Bluetooth, WiFi, and a smartphone to send the reading. When one of these connections is lost, patients, the device supplier, and sometimes the physician’s office must spend time pairing, synching, or troubleshooting to regain the connection. This leads to missed readings and lost data that is critical to diabetes management.

“The impact of these disconnections can be significant,” the blog reads. “Missing glucose data can make it difficult for users to manage their condition effectively, potentially leading to hyperglycemia or hypoglycemia. Moreover, constant connectivity issues can be frustrating, reducing the overall user experience and trust in the technology.”
 
There is also concern about the accuracy of CGMs. One reason for inaccuracy with CGM readings could be the ways in which they measure glucose. With traditional blood glucose monitoring, patients are measuring glucose amounts present in their blood at that exact moment in time. In contrast, CGM devices pierce the top layer of skin and measures glucose in the interstitial fluid and not actual blood, which is not as accurate. CGMs may also require periodic calibration with traditional blood glucose meters. For example, an Abbott Laboratories news release about Libre Rio, an over-the-counter CGM, states, “if readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions.”
 
While CGM devices may lead to improved glycemic control in patients with diabetes, there are many issues with the technology, and these issues can often lead to patient dissatisfaction and discontinued use, according to one study.¹ Among the top reasons cited in the study was varying levels of accuracy between sensors, particularly on the first and last day of wear. This led to 59% of participants stopping use of their CGM device for at least one month. Another 32% of users continued to test their blood sugar using traditional blood glucose monitoring six or more times a week, to ensure they were getting accurate blood glucose readings.
 
“These critical issues can lead to uncertainty, frustration and lack of adherence to testing protocols among patients,” Pittock said. “Smart Meter’s iGlucose Plus meets the highest standards for accuracy and as soon as the patient tests, the result is sent immediately to a provider or healthcare organization.”
 
Smart Meter is a supplier of cellular Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) solutions. The company empowers a nationwide network of SmartPartners who work directly with healthcare providers to transform patient care. Millions of vital health data readings are reliably delivered across its platform to enable real-time, better-informed healthcare. Smart Meter’s proprietary patient-friendly, cellular U.S. Food and Drug Administration-registered monitoring devices are connected to an exclusive AT&T 4/5G private data network to ensure an engaging patient experience for improved adherence. 

Reference 
¹ Perceptions of Continuous Glucose Monitoring Systems in the T1D Exchange Diabetes Registry: Satisfaction, Concerns, and Areas for Future Improvement – PMC (nih.gov)