Continuous Glucose Monitoring (CGM)

What is Continuous Glucose Monitoring (CGM)?

  • CGM is a sensor-based technology that measures blood glucose from interstitial fluids
  • The CGM measures glucose at regular and frequent intervals, 24 hours per day.
  • The sensor eliminates the need to manually take blood glucose finger sticks and provides insight on how your blood glucose levels change after a meal, at night or during and after exercise.
  • The CGM is worn discreetly on your body. You can shower with it, swim and perform your typical activities of daily living. Depending on the manufacturer the sensor is replaced every 10-14 days.
  • The CGM can also be used when the patient has an insulin pump.
  • The sensor wirelessly transmits your glucose reading to a receiver.

Perceived Benefits

  • No need to stick yourself to determine your blood glucose levels
  • If you have tendencies to have hypoglycemia (low blood sugar) the CGM can warn you of impending hypoglycemia
  • Learn what happens after exercise or a meal. Also it can be helpful to know what happens during the night while your asleep.
  • Learn how to stay in the "control zone" longer
  • You can share your information with your Doctor or Family Member.

Who is covered?

Coverage for a CGM may vary depending on your health plan. You should know upfront if you have any deductibles or co-pays.

  • The patient must be a Diabetic and insulin Dependent either Type 1, Type 2 or Type 3 (Gestational).
  • The patient must take insulin 3 times per day and have a track history of manually testing blood glucose 4 times per day for a minimum of 2 months.
  • The patient must have an initial "Face to Face" examination by the prescribing Doctor then every 6 months thereafter (this requirement varies among health plans). It must be documented that the patient has been properly educated on how to use the CGM and a treatment plan must be established that includes the use of a CGM.
  • The patient must have an uncontrolled HGBA1C >7%
  • The patient must have had hypoglycemia < 54 mg/dl at least 3 times without symptoms OR hypoglycemia <54 mg/dl one time with symptoms. Symptoms may include but are not limited to; mental status changes, brain fog, light headedness, dizziness, fatigue, sweating, syncope, pre-syncope or palpitations. 

What's included?

  • Most insurances will allow a 90 day supply of CGM which includes; 10 sensors and 1 transmitter. A reader receives the transmitted glucose readings and insurances allow for one receiver every 1- 5 years. If the patient uses a Smart Phone it can also act as a receiver. 
  • The warranty of a reader is typically 4 years
  • Most insurances will not pay for both a manual glucometer and CGM at the same time.