Diabetes management has come a long way but barriers to effective treatment still exist

Health-care professionals have borne witness to a remarkable transformation in the management of diabetes in recent years. The invention of sensor-based glucose monitoring systems has ushered in a new era of empowering people living with Type 1 and Type 2 diabetes, providing invaluable insights, education and support.

Notably, the Diabetes Canada Clinical Practice Guidelines, updated in 2021, recommend the use of sensor-based glucose monitoring systems for individuals with Type 2 diabetes utilizing basal-bolus insulin therapy. These systems offer a lifeline to those struggling to attain their A1C targets, helping to reduce both A1C levels and the duration of low blood-sugar episodes.

While the potential benefits of sensor-based glucose monitoring systems are well-understood by health-care professionals, we must acknowledge the barriers faced by individuals living with diabetes and the importance of having proactive conversations to address them.

Recognizing barriers to adoption

A recent survey by Leger Marketing, on behalf of Abbott’s Diabetes Division, revealed that a substantial number of people with Type 2 diabetes are not using sensor-based glucose monitoring systems because they don’t think they need these tools or don’t believe they have insurance coverage for them.

Moreover, the survey unveiled a compelling truth – that patients who overcome their apprehension over trying this new technology regain a sense of control over their condition. More than two-thirds (68 per cent) of individuals who use a sensor-based glucose monitoring system admitted they felt intimidated by these devices before giving them a try and now can’t imagine managing their diabetes without them. The majority also reported that using these devices allowed them to feel like they could live with diabetes on their own terms (89 per cent) and have more freedom in their ability to manage their chronic condition (80 per cent).

Benefits of sensor-based glucose monitoring systems

Sensor-based glucose monitors enable users to gain a profound understanding of how their nutrition choices, physical activity and medication influence their glucose levels. These tools automatically measure and continuously store glucose readings, eliminating the need for routine finger pricks and helping those living with the chronic condition make treatment decisions more confidently.

  1. Convenience and frequency of monitoring. One of the most significant advantages of sensor-based glucose monitoring systems is that they eliminate the need for painful and inconvenient finger pricks. As well, traditional blood glucose meters (BGMs) provide readings at a single moment in time, potentially missing critical highs and lows. Sensor-based monitors offer a comprehensive, real-time view of glucose levels throughout the day, enabling individuals to make immediate adjustments to their nutrition, physical activity and medication. This convenience encourages more frequent monitoring, aligning with health-care recommendations for better diabetes management.
  2. Improved clinical outcomes. From a medical standpoint, glucose monitoring technology has been shown to yield better clinical outcomes. Ongoing, accurate monitoring allows for timely intervention, reducing the risk of extreme high and low blood sugar episodes. Achieving and maintaining target A1C levels becomes more manageable, resulting in improved overall health for individuals with diabetes.

Addressing costs

The cost of sensor-based glucose monitoring systems can be an obstacle for many individuals living with diabetes, particularly those who are retired and reliant on pension funds or personal savings to cover their expenses. However, there is good news on this front. In recent years, coverage for these devices has expanded. For instance, the FreeStyle Libre 2 system is now publicly reimbursed in several Canadian provinces, including Ontario, Quebec, Manitoba and Prince Edward Island. Additionally, many private insurers provide coverage for sensor-based glucose monitoring systems, offering potential financial relief for those who are still employed. Health-care providers should encourage individuals to explore their coverage options and engage in discussions to determine the best way to access these life-enhancing tools.

Embracing change and seeking support

Adopting any new technology can be unnerving, and many individuals may feel intimidated by using glucose monitoring technology. When discussing these systems with their health-care team, they should inquire about educational and training programs offered by manufacturers. Diabetes care clinics also provide valuable support to help people get started with these devices.

Diabetes self-management education is a vital component of the transition to sensor-based glucose monitoring systems. Structured educational programs have consistently demonstrated significant benefits, including greater A1C reduction, increased time in the target glucose range and reduced diabetes-related distress when compared to standard care practices.

With their ability to provide continuous, painless monitoring, sensor-based glucose monitoring systems empower individuals living with diabetes to make informed decisions regarding their nutrition, activity and medication. Embracing these life-changing technologies can lead to improved clinical outcomes, enhanced quality of life, and a more confident approach to daily diabetes management.

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Jeremy Gilbert


Dr. Jeremy Gilbert is an endocrinologist in Toronto and the endocrinology section chair at the Royal College of Physicians and Surgeons of Canada. He is a national editor for the Canadian Journal of Diabetes, a member of the steering committee of the Diabetes Canada Guidelines and the national lead for dissemination and implementation for the Diabetes Canada Guidelines. He has received numerous awards for outstanding teaching, including the 2021 Canadian Society of Endocrinology and Metabolism’s Harvey Guyda Educator of the Year Award.

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