Continuous Glucose Monitoring in Non-Insulin Type 2 Diabetes

Abstract

Abstract Diabetes mellitus, a global health concern, is characterized by complex pathophysiology and presents diverse clinical challenges. Effective management of diabetes hinges on key principles such as glycemic control, lifestyle modifications, and adherence. In non-insulin-requiring Type 2 diabetes (T2D), persistent elevated HbA1c levels remain a challenge. Continuous glucose monitoring (CGM) is pivotal, serving as a cornerstone for optimizing therapy, mitigating hypoglycemia, and reducing the financial burden. Unlike traditional self-monitoring of blood glucose (SMBG), CGM offers continuous, pain-free data, aiding treatment decisions. This review explores CGM’s multifaceted role in non-insulin requiring T2D, scrutinizing HbA1c reduction, glycemic variability, time in range (TIR), exercise, dietary management, early comorbidity detection, and cost-effectiveness. CGM empowers users to monitor and manage their glycemic levels, making it an effective tool for HbA1c reduction. Glycemic variability poses risks, and CGM provides valuable metrics like time below range (TBR), time in range (TIR), and time above range (TAR). CGM effectively minimizes glycemic variability and improves TIR in non-insulin requiring T2D. Additionally, CGM aids in real-time decision-making for physical activity and dietary choices, enhancing the effectiveness of lifestyle modifications. It also assists healthcare providers in identifying early signs of comorbidities, particularly cardiovascular disease, and diabetic retinopathy, through monitoring glycemic variability. While CGM devices may incur costs, studies suggest their cost-effectiveness, considering long-term benefits and complications prevention. This review underscores CGM’s importance in T2D management, even for non-insulin-requiring individuals. Recommendations include CGM use for newly diagnosed people with T2D, those with uncontrolled diabetes, and those adjusting treatments. Personalized glycemic control goals are proposed, aligning CGM’s role in managing hypoglycemia, hyperglycemia, and glycemic variability in T2D. As CGM technology advances and becomes more accessible, it is poised to play an increasingly pivotal role in diabetes management. Crucially, CGM should be employed in consultation with healthcare providers, considering regional disparities in cost-effectiveness and accessibility influenced by insurance coverage and government interventions.