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

Featured Article

Take the sting out of monitoring glucose levels
Benefits Canada - March 5, 2021

Featured Free Webinar

Digital Diabetes Care: Improving employee health, productivity & safety
from the Benefits Canada Chronic Disease @ Work Conference - 2021

Featured Resource

Digital Diabetes Care: Virtual pathways to improved employee health,
productivity & safety with data-driven disease management
Employee Health Plan Policy Discussion Paper

Featured Payer Update

B.C. expands PharmaCare coverage to include life-changing diabetes monitor

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

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

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
Webinar

Advancing Real-Time CGM Use for Improved Patient Outcomes [Series of Free CE Programs] – Medscape Education Diabetes & Endocrinology – 2021

  1. Expanding the Pharmacist’s Role in rtCGM Use and Education in Practice
  2. Clinical and Technology Innovations with Interoperable Real-Time CGM
  3. Completing the Picture with Clinical Use of Real-Time CGM
  4. rtCGM in Primary Care: Quick Tips for the Busy Clinician
Webinar

Continuous Glucose Monitoring: The Evolution of Diabetes Care [Free CE] – Pharmacy Times Office of Continuing Professional Education – 2021

Webinar

Harnessing Technology to Improve Glycemic Control: The Role of Continuous Glucose Monitoring [Free CE] – Med Learning Group – 2021

Webinar

Real-World, Value-Added Benefits of Real-Time CGM in an Integrated Health System [Free CE] – ManagedCareCGM.com – 2021

Webinar

The Value of Real-time CGM in Reducing Hospitalizations Among Plan Beneficiaries of Advanced Age [Free CE] – ManagedCareCGM.com – 2020

Webinar

Best Practices in Diabetes Care: Pharmacy Benefit Coverage for Real-Time CGM with Member Outreach Intervention [Free CE]- ManagedCareCGM.com – 2020

Webinar

The Value of Continuous Glucose Monitoring during the COVID-19 Pandemic and New Era of Digital Healthcare [Free CE] – ManagedCareCGM.com – 2020

Webinar

The Value of Real-Time CGM to Reduce Diabetes Costs [Free CE] – ManagedCareCGM.com – 2020

Webinar

Best Practices in CGM Benefit Design: Payer Experience Moving CGM Coverage from the Medical to the Pharmacy Benefit [Free CE]- ManagedCareCGM.com – 2020

Webinar

Continuous Glucose Monitoring and the Opportunities for Optimal Diabetes Care and Cost Management [Free CE]- ManagedCareCGM.com – 2019