This site is intended for heath plan professionals in Canada.

This site is intended for health plan professionals in Canada.

U.S. professionals should visit ManagedCareCGM.com

Continuous Glucose Monitoring

Continuous Glucose Monitoring - CGM

Insights & Education for Health Benefit Plan Professionals in Canada

Cost-effectiveness of Real-Time Continuous Glucose Monitoring

Key findings from a cost-effectiveness analysis (CEA) for adults with insulin-treated
type 2 diabetes in Canada suggests the use of Dexcom G6 Real-Time Continuous Glucose
Monitoring (rtCGM) provides a cost-effective disease management option relative to
SMBG. The CEA is built on data from the growing body of evidence that shows rtCGM
to be transformative for many people living with diabetes.

New Video Resource

Diabetes Canada Clinical Practice Guidelines:
Recommendations for
Continuous Glucose Monitoring (CGM)

Click Here to Watch Now

Featured Conference Update

Latest Research in Diabetes Technology:
Highlights from ATTD 2022

Featured Resource

Continuous Glucose Monitoring:
An Opportunity for Population-Based Diabetes Management

Featured Update

2021 Update from the Diabetes Canada Clinical Practice Guidelines
Expert Working Group on Blood Glucose Monitoring
in Adults and Children with Diabetes

Featured Payer Update

Non-insured Health Benefits Program Now Covers Dexcom G6
Continuous Glucose Monitoring System for Children and
Adolescents on Intensive Insulin Therapy

Featured Publication

Comparing real-time and intermittently scanned continuous glucose monitoring in adults
with type 1 diabetes (ALERTT1): a 6-month, prospective, multicenter, randomized
controlled trial [Summary]

In the News

Public Coverage & Policy Updates

New Resource

Glucose Sensor Technology available for Islanders living with Diabetes – PrinceEdwardIsland.ca – May, 2022

New Resource

Ontario Announces Public Coverage for the Dexcom G6 Continuous Glucose Monitoring System under the Assistive Devices ProgramBusiness Wire – March 7, 2022

New Resource

Continuous Glucose Monitors added to both government and employer-sponsored drug plans in AlbertaPharmacy Benefact – February 1, 2022

Guideline/Policy/Report

Green Shield Canada now reimbursing continuous glucose monitoring systems at pharmacy GSC Pharmacy Update – November, 2021

Guideline/Policy/Report

Updated Coverage Status of Glucose Monitoring Devices by Provincial Jurisdiction – Diabetes Canada – October 2021

Guideline/Policy/Report

Effective September 28, 2021, Continuous Glucose Monitoring (CGM) and Flash Glucose Monitoring (FGM) systems are covered by Manitoba Pharmacare for eligible clients 25 years old and younger – Province of ManitobaSeptember 28, 2021

Guideline/Policy/Report

Expanded medical device coverage for people with diabetes in BCBC Gov News – June 11, 2021

News

Enhanced Supports For Saskatchewan Residents With DiabetesSaskatchewan.ca – June 1, 2021

News

Diabetes organization pleased with Manitoba government’s commitment to help youth with the diseaseCTV News Winnipeg – April 8, 2021

News

Manitoba & Saskatchewan Announce Expanded Coverage for Diabetes TechnologyJDRF – April 7, 2021

News

P.E.I. government makes important investment in support of Islanders living with diabetesDiabetes Canada – March 17, 2021

News

Employers play important role in preventing and managing diabetesMedavie Blue Cross – November 13, 2020

News

Government of Yukon will fully fund the costs of continuous glucose monitors for all Yukonerswww.yukon.ca – October 1, 2020

In The Know: Introduction To CGM

Continuous Glucose Monitoring (CGM) is a method to track glucose levels throughout the day and night. CGM systems take glucose measurements at regular intervals and translate the readings into dynamic data, providing glucose direction and rate of change. Having this context helps CGM users proactively manage glucose highs and lows, and gives added insight into impacts that meals, exercise and illness may have on an individual’s glucose levels. CGM can also contribute to better diabetes management by helping to minimize the guesswork that comes with making treatment decisions based solely on a number from a blood glucose meter reading. Studies have shown that CGM systems may help reduce A1C levels and reduce hypoglycemia, whether users are on insulin injections or pump therapy.

CGM Product Comparisons

Standalone Continuous Glucose Monitoring and Flash Glucose Monitoring Comparison Chart

Product Attributes and Performance

G6® Continuous Glucose

Monitoring System (Dexcom)1

FreeStyle® Libre Flash Glucose

Monitoring System (Abbott)2

Monitoring Method

Real-Time CGM

Intermittent Scan CGM

Data Availability

Continuously available without user intervention

Available with user intervention
(i.e. must scan sensor)

Age Indication

2 years and older

18 years and older

Health Canada Approved Sensor Placement

Upper Arm, Abdomen (adults)

Abdomen, Upper Buttocks (pediatrics)

Upper arm

Factory Calibrated

Yes

(manual calibration optional)

Yes

Approved to Replace Fingerstick Blood Glucose Testing for Treatment Decisions

Yes
Except fingerstick confirmation when symptoms don’t match readings or G6 doesn’t show number, arrow, or both

Yes

Except fingerstick confirmation is required:

  • During times of rapidly changing glucose
  • To confirm hypoglycemia
  • To confirm impending hypoglycemia
  • When symptoms don’t match readings
  • During first day of wear

Approved to Aid in the Detection of Episodes of Hyperglycemia & Hypoglycemia

Yes

No

Health Canada Warning for Patients Diagnosed with Hypoglycemia Unawareness

No

Yes

Sensor Wear

10 days

14 days

Sensor Survival [Adults ≥18]

94% @ 10 days

86% @ 14 days

Sensor Expiration Warning

Yes; 24 h, 6 h, 2 h, 30 min

No

Sensor Warm-up Time

2 h

1 h

Water Resistance

Up to 24 hours in 2.4 meters [8 feet]

Up to 0.5 hours in 1 meter [3 feet]

Known Interfering Substances

Acetaminophen if dosed > 1 g every 6 h in adults
Hydroxyurea causes falsely higher readings

Ascorbic Acid at >500 mg may cause falsely higher readings
Salicylic Acid at >650 mg may cause falsely lower readings

Approved for Use with Automated Insulin Delivery (AID) Systems

Yes

No

Insulin Pump integration

Yes

Tandem t:slim X2® with AID

No

Mobile Device Connectivity

Yes

Apple iOS and Android via Bluetooth

(See list of supported devices at http://www.dexcom.com/compatibility)

Yes

iOS and Android can be used to scan sensor for data via near field communication

Smart Watch Compatibility

Yes

(See list of supported devices at http://www.dexcom.com/compatibility)

No

Protective Safeguards (Alerts/Alarms)

Customizable Threshold Alerts / Alarms [Low / High]

Yes

No

Predictive Low Glucose Alert [Within 20 mins]

Yes

No

Urgent Low Glucose Alarm

Yes

No

Rapidly Rising/Falling Rate of Change Alerts

Yes

(optional)

No

Alert Schedule

[i.e. Different Alert Setting at Night]

Yes

(optional)

No

Share Alerts / Alarms

Yes

(optional)

No

Signal Loss Alert / Alarm

Yes

(optional)

Yes

Repeat Alerts / Alarms

Yes

(optional)

No

Accuracy

MARD (Average % Discrepancy Between Sensor Readings and YSI Glucose)

9.0%

9.5%

Percentage of Readings within ±  20% /± 1.11mmol/L

94%

91%

Accuracy in Hypoglycemia: Concurrence of Sensor Readings with YSI-Measured Values in Low Range [Adult: 2.2-3.3 mmol/L]

68%

29%

Data Management, Reporting & Sharing

Data Availability

Continuously available without user intervention

Available with user intervention

(i.e. user must scan sensor)

Data Storage

Automatically & continuously stored without user intervention

Data stored when user scans sensor

Sensor must be scanned at least once every 8 h to prevent data loss

Data Sharing / Remote Monitoring

Yes

Readings continuously automatically shared with followers

Yes

Readings are shared when the user scans their sensor

Trend Arrows

Yes

Yes

Trend Graphs

1, 3, 6, 12, 24 h

8, 24 h

Smart Phone Push Notifications with Insights, Coaching

Yes

Automated via Dexcom CLARITY® App

Opt-In

No

Cloud-Based Data Management Program

Yes

Automated upload via Dexcom CLARITY® Mobile App

Yes

LibreView®

Data stored and shared when user scans sensor

Sensor must be scanned at least once every 8 h to prevent data loss

  1. Dexcom G6 CGM System User Guide
  2. FreeStyle Libre Flash Glucose Monitoring System User’s Manual & Quick Reference Guide

Video Resources Review Publications

In The Workplace: Diabetes & CGM Health Plan Policy

In Publication: CGM Health & Economic Evaluations

Clinical Guidelines & Research

Find the latest expert treatment guideline recommendations, clinical trials, and real-world evidence.

View All Resources 🍁 = Canadian Content
New Resource

Blood Glucose Monitoring in Adults and Children with Diabetes: Update 2021Canadian Journal of Diabetes – 2021

Guideline/Policy/Report

American Association of Clinical Endocrinology [AACE] Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes MellitusAACE Endocrine Practice – June 2021

Guideline/Policy/Report

Diabetes Technology Standards of Medical Care in Diabetes 2021 – American Diabetes Association – Diabetes Care – 2021

Research

Benefits of Real-Time Continuous Glucose Monitoring in Pregnancy Diabetes Technology & Therapeutics – March 2021

Guideline/Policy/Report

NICE Guideline Update: Diabetes in pregnancy: Management from preconception to the postnatal periodwww.nice.org.uk – 2020

Research

Glycemic Outcomes in Adults With T1D Are Impacted More by Continuous Glucose Monitoring Than by Insulin Delivery Method: 3 Years of Follow-Up From the COMISAIR StudyDiabetes Care – 2020

Research

Alarm Settings of Continuous Glucose Monitoring Systems and Associations to Glucose Outcomes in Type 1 DiabetesJournal of the Endocrine Society – 2020

Guideline/Policy/Report

Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled TrialsDiabetes Care – 2020

Research

Glycemic Outcomes with Early Initiation of Continuous Glucose Monitoring System in Recently Diagnosed Patients with Type 1 DiabetesDiabetes Technology & Therapeutics – 2019

New Resource

Clinical Practice Guidelines: Monitoring Glycemic ControlCanadian Journal of Diabetes – 2018🍁

Research

A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with Type 1 diabetes and impaired awareness of hypoglycemiaDiabetic Medicine – 2018

Research

Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions, and Quality of Life: A Real-World StudyJournal of Clinical Endocrinology & Metabolism – 2018

Research

Baseline Glycated Hemoglobin Values Predict the Magnitude of Glycemic Improvement in Patients with Type 1 and Type 2 Diabetes: Subgroup Analyses from the DIAMOND Study ProgramDiabetes Technology & Therapeutics – 2018

Guideline/Policy/Report

Clinical Implications of Real-time and Intermittently Scanned Continuous Glucose MonitoringDiabetes Care – 2018

Research

Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections: The GOLD Randomized Clinical TrialJAMA – 2017

Research

Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical TrialJAMA – 2017

In The Spotlight

In Practice: CGM Resources For Clinical Professionals

Continuing Education Programs

Gain insights from leaders in the field of diabetes and health benefits in these Continuing Education activities.

View All Resources 🍁 = Canadian Content