People with diabetes can access information regarding their blood glucose levels at any time with continuous glucose monitoring (CGM). There is scientific evidence that CGM can help improve clinical outcomes for people with type 1 and type 2 diabetes who are treated with insulin; however, there is less specific structure to its role with type 2 diabetes.
Three expert panelists will discuss CGM and type 2 diabetes, including the technology’s potential use as a preventative tool and its role for people living with diabetes who are treated with insulin compared to those who are not. The symposium Continuous Glucose Monitoring in Type 2 Diabetes—Are We There Yet? will be Saturday, June 24, at 8:00 a.m. PT in Ballroom 20A-C of the San Diego Convention Center. This session also will be available via livestream for registered meeting participants.
Anders Carlson, MD, an adult endocrinologist and researcher at the International Diabetes Center, will discuss how CGM could play a role in prediabetes and obesity. Observational data point to the benefits of CGM as a tool to modify activity, diet, and behavior, he noted.
“What would that look like for someone without diabetes to use CGM?” he said. “We tend to think so much about avoiding low and high glucose levels, about adjusting medications, or about titrating insulin, but how can you use the real-time information from CGM to guide diet and behavior changes?”
The topic is growing in relevance because of increases in obesity and obesity-related complications, and with more people being diagnosed with type 2 diabetes, Dr. Carlson continued. He sees potential to use CGM in clinical trials for behavior and nutrition changes, and as a prevention tool as opposed to just a glucose management tool.
“We need to start further upstream and try to work on prevention,” he said.
Ronnie Aronson, MD, Chief Medical Officer at LMC Diabetes & Endocrinology, will discuss the role of CGM in type 2 diabetes that does not require insulin treatment.
CGM—both real time and intermittently scanned—has accumulated solid evidence validating its impact in improving glycemic control for people living with diabetes and using insulin. The evidence applies to those with type 1 and type 2 diabetes, as well as insulin users requiring multiple daily injections and basal-only insulin regimens.
However, neither real-time nor intermittently scanned CGM had been investigated through a randomized controlled trial with defined primary outcomes in people who have type 2 diabetes and are not using insulin until the IMMEDIATE study, Dr. Aronson said.
In IMMEDIATE, researchers used a first-generation FreeStyle Libre monitor on people with type 2 diabetes not using insulin. The study, published in the journal Diabetes, Obesity and Metabolism, found a significant benefit of 10% greater time in range, along with a significant A1C benefit of 0.3 (pre-defined secondary outcome).
The population at the center of his discussion is several-fold larger than the “CGM-proven” populations to date, Dr. Aronson said. It is also the population at high risk for diabetes complications and poor cardiovascular outcomes.
“Improving diabetes control through education and the feedback of CGM would appear to be a large opportunity, without requiring the addition of yet another therapy,” he concluded.
Janet B. McGill, MD, Professor of Medicine in the Division of Endocrinology, Metabolism and Lipid Research at Washington University, will discuss intermittently scanned CGM versus real-time CGM for people with insulin-treated type 2 diabetes.