Individuals with Type 1 and Type 2 diabetes, including children and pregnant women
Care Setting
Outpatient and home-based diabetes management
Key Highlights
Continuous glucose monitoring (CGM) has improved accuracy over two decades, with current devices achieving MARD between 7.8% and 10.6%, enabling nonadjunctive use.
Automated insulin delivery (AID) systems integrate CGM data with insulin pumps using proprietary algorithms to optimize insulin dosing and improve glycemic control, especially in Type 1 diabetes.
Connected insulin pens (smart pens) expand treatment options for both Type 1 and Type 2 diabetes by facilitating optimized insulin administration.
Guideline-Based Recommendations
Diagnosis
Use CGM to monitor glucose levels continuously to improve detection of glycemic patterns beyond traditional SMBG.
Confirm CGM accuracy with SMBG during initial use or as recommended.
Management
Incorporate CGM and AID systems to improve glycemic control, reduce hypoglycemia, and enhance quality of life in patients with Type 1 and Type 2 diabetes.
Individualize treatment goals and technology use based on patient-specific factors and diabetes type.
Utilize connected insulin pens to support insulin titration and adherence.
Monitoring & Follow-up
Regularly assess CGM data including time in range (TIR), HbA1c, and hypoglycemia frequency to guide therapy adjustments.
Monitor patient self-efficacy and quality of life as part of diabetes technology implementation.
Risks
Be aware of potential provider hesitancy due to earlier CGM accuracy limitations; ensure use of FDA-approved devices with validated accuracy.
Consider disparities in access and utilization of diabetes technologies.
Patient & Prescribing Data
Patients with Type 1 and Type 2 diabetes, including children and pregnant women
Use of CGM and AID systems improves glycemic control (HbA1c reduction, increased time in range), reduces hypoglycemia, and enhances patient satisfaction and quality of life.
Clinical Best Practices
Select diabetes technology based on individual patient needs, preferences, and clinical characteristics.
Educate patients on the use and interpretation of CGM and AID data to promote self-efficacy.
Incorporate technology as part of a comprehensive diabetes management plan including lifestyle and pharmacologic therapy.
Regularly review and update treatment goals in collaboration with patients.
Address barriers to technology access and utilization to reduce disparities.
Researchers found that patients with higher waist circumference and lower grip strength had the greatest risk for developing type 2 diabetes during long-term follow-up.
