Continuous glucose monitoring (CGM) is no longer limited to type 1 diabetes (T1D) and may play a significant role in shaping the care of type 2 diabetes (T2D).

Emerging evidence indicates that broader use could improve glycemic control, support individualized treatment, and reduce complications, with implications for routine clinical practice.

Established Benefits

In T1D, CGM systems consistently demonstrated clinical benefits, including reductions in hypoglycemia, predictive alerts, improved glycemic control, lower A1c levels, and increased time in range.

Population-level outcomes are also notable, with reduced healthcare use, especially for emergency care, and fewer complications. In Belgium, CGM devices are reimbursed for T1D, and approximately 80% of individuals use them.

In T2D, CGM use remains limited, primarily to individuals treated with insulin, with partial reimbursement in selected settings. A broader implementation of this approach may yield similar benefits.

Tech Advances

Several implementation strategies are under consideration for T2D. These include intermittent CGM use, such as 15-day monitoring periods repeated multiple times per year, and earlier initiation of monitoring at diagnosis.

Compared with self-monitoring using fingerstick testing and periodic A1c assessments, CGM provides higher-resolution monitoring. Advances in sensor technology have also improved the reliability of these systems.

Current CGM systems provide detailed metrics, including mean interstitial glucose levels, glycemic variability, and time above and below the normal range. These parameters allow for a more comprehensive assessment of glycemic patterns than traditional approaches.

These data support more refined phenotyping of T2D, particularly during diagnosis. Clinicians can better evaluate the treatment response and anticipate the need for treatment intensification.

At the individual level, patients can observe how daily behaviors such as diet, physical activity, sleep, and stress influence glucose levels. This real-time feedback supports sustained lifestyle modifications.

Digital health platforms may further strengthen these preventive strategies. Tools that combine questionnaires and lifestyle assessments can help identify individuals at risk for T2D earlier, thus improving opportunities for intervention in prediabetes.

At both the individual and population levels, aggregated CGM data may identify clinically relevant subgroups within T2D, thereby supporting more targeted management.

Several companies, including Belgian start-ups, are developing software and mobile applications to improve data interpretation (in some cases using AI models) and support prevention. One initiative focuses on pharmacists and provides easy-to-use tools to identify at-risk individuals at an early stage.

Another development is the emergence of next-generation CGM sensors capable of measuring additional biomarkers, such as ketones and lactate. These sensors use photonic technology for glucose measurement.

Further technological progress is expected, with multifunctional sensors likely to extend their capabilities beyond those of current CGM systems.

This story was translated from MediQuality, part of the Medscape Professional Network.