continuous glucose monitors continue to change diabetes care and now access needs to catch up
4 minute read
continuous glucose monitoring isn’t a distant innovation—it exists now, and it’s already transforming the lives of those who can access it. but real progress in healthcare and the future of diabetes management means ensuring that transformation is equitable.
getty images
stay up to date on this topic
according to diabetes canada, nearly 12 million canadians live with diabetes. this number is expected to increase to more than 14 million over the next decade. as diagnosis rates continue to rise, technology such as continuous glucose monitoring (cgm) has tried to keep pace with the needs of patients.
many may remember, not fondly, the days of ‘fingersticks’—a routine prick of the finger with a small needle to draw blood—or urine samples used to test and monitor sugar levels and determine insulin doses.
“even as far as a few decades ago, people who wanted to know what their blood sugar levels were had to have their urine sampled,” says dr. akshay jain, an endocrinologist out of surrey, b.c.
“the problem with this technique (and fingersticks) was that they only gave you a snapshot; it just tells you what your blood sugar is right at that point in time. it doesn’t tell you if it’s going up, going down, staying steady, which means multiple tests throughout the day were needed to get a better idea.”
these days, cgm technology is able to give real-time data to the smartphone of its user, providing an immediate response to glucose levels. this instant visibility makes supervision of insulin levels and blood sugar much easier to manage.
devices such as abbott’s new freestyle libre 3 plus and dexcom’s g7 are leading the way in glucose monitoring, giving patients the ability to manage their diabetes more effectively.
“for most individuals living with diabetes, there’s a constant guesswork going on. you have to look at the meal in front of you and guess how it will affect your blood sugar. you’ll have to estimate how your blood sugar will change overnight, while working out, anytime,” dr. jain says. “having continuous glucose monitoring eliminates a lot of guesswork, because you’re seeing in real time how the sugars are changing.”
advertisement
the evolution of these tools also comes down to their size and how much they interfere with your day-to-day activities. for example, the libre 3 plus features the world’s smallest glucose sensor for patient-applied sensors, which continues to reduce the disruptive nature that bulky technology can have on a person living with diabetes.
“people with diabetes are often living with a lot of stigma. they may be judged by people around them. so having a very tiny sensor eliminates something drawing attention to your body,” says dr. jain, emphasizing that the future of cgm isn’t in the technology, but how we use it.
“it’s a behavioural monitoring device. it gives you constant feedback. let’s say somebody eats pasta, and they see their sugar skyrocket, then they know that this particular meal is more likely to affect their blood sugar, and can make modifications (to their diet),” he says. “it’s also positive reinforcement, if they do something that improves their sugar balance, then they are more likely to continue to do those beneficial things.”
diabetes technology advances without equal access
the impact of diabetes management technology can’t be understated. however, technological progress and perfection alone aren’t enough while people continue to deal with accessibility issues.
according to research, diabetes is more prevalent among lower-income communities, which is one of many determinants of health alongside environment, employment, education and access to health services. availability of healthier food and medication can be limited, and education about blood sugar levels and diabetes isn’t as prominent.
the newly-launched libre 3 plus is covered by many insurance companies for people living with diabetes and insulin users. the sensor and reader are also covered by the non-insured health benefits (nihb) program for first nations and inuit individuals, and other federal and provincial government-sponsored drug programs. dexcom also recently announced coverage for the g7 under the ontario drug benefit in addition to private insurance, nihb and the assistive devices program (adp) in the province.
sponsored by:
diabetes canada
advertisement
this is a step forward, but it isn’t universal. access to cgms in canada remains inconsistent, with public funding and eligibility varying by province. while private insurance and nihb offer broader support, gaps in coverage still leave many without access.
for many canadians, the question isn’t if the technology works—it’s whether they can access it and afford to use it.
“across canada, it’s important that we look at improving current access to cgm,” dr. jain says. “i would be a strong advocate towards having this kind of technology available to people that need it the most.”
continuous glucose monitoring isn’t a distant innovation—it exists now, and it’s already transforming the lives of those who can access it. but real progress in healthcare and the future of diabetes management means ensuring that transformation is equitable.
as diabetes rates rise across the country, so too must our responsibility to make tools like cgm accessible to all canadians, regardless of income, location or background. equity, not just advancement, has to define the future of diabetes care in canada.
“the key with any technology is giving information that is actionable,” dr. jain says. “with advanced glucose monitoring technology (we are) able to make a positive change in an individual’s overall health.”
share story
