Enhancing Type 2 Diabetes Care With CGM Integration: Insights From an Italian Expert Group

Abstract

Type 2 diabetes (T2D) is a pandemic and strongly impact patients' prognosis. Several barriers may hamper the achievement of good glycaemic control, which is the aim of diabetes care. These include but are not limited to poor treatment adherence, poor self-management, and heterogeneity of the disease context. Diabetes self-management is critical, particularly in insulin-treated patients and it is largely based on glucose monitoring, which allows recording glucose levels to make informed decisions with respect to meals, exercise, and other daily-life activities. For decades, glucose monitoring has been based on self-measurement of capillary blood glucose, which has some obvious important limitations. With the start of the new century, systems for continuous glucose monitoring (CGM) have become available. These systems measure subcutaneous interstitial glucose levels in a continuous or intermittent manner. They allow a better description of daily glucose pattern and glycaemic trend, a more accurate identification of glucose peaks and identification of otherwise unrecognised hypoglycaemic episodes, and a more reliable assessment of the stability of glycaemic control. CGM has been repeatedly shown to improve glycaemic control and reduce the risk of hypoglycaemia in type 1 diabetes (T1D). Over the years however, evidence has been gathered on the CGM use in T2D on different treatment regimens and wider applications are clearly desired. The aim of this expert opinion paper is to summarise the currently available evidence on CGM use across the whole spectrum of T2D and suggest practical indications beyond current guidelines.