Did you know that diabetes is a leading cause of chronic kidney disease (CKD)? To prevent the progression of CKD, patients with diabetes need to maintain good blood sugar levels, and monitor those levels to ensure they stay in a healthy range. 

Pricking your finger to test blood with a blood sugar meter has been the traditional method for monitoring blood sugars. Doing this multiple times a day can be a burden. Fortunately, new technology is making it easier for patients to track their sugar, no matter where they are. Learn more about a medical device called a continuous glucose monitor (CGM), including how it works, who it benefits, and what it costs.* 

What is a CGM?

A CGM is a wearable device that can measure your blood glucose all day and night. The CGM contains a small sensor that is inserted beneath the skin, often on the belly or arm. Most are waterproof and have an adhesive patch to keep them in place. Sensors usually last between 7-14 days, and need to be regularly replaced. 

A CGM is wirelessly connected to a separate device, such as a smartphone app or insulin pump, which allows both you and your doctor to keep track of your blood sugar levels. You are able to schedule automatic blood sugar checks throughout the day, and will be alerted if your levels are dangerously high. 

Who can use a CGM?

Patients with type 1 or type 2 diabetes may benefit from a CGM. If you have type 2 diabetes, have well-controlled blood sugars, and are not on insulin, your condition may not warrant a CGM. A CGM requires a medical prescription, and doctors look for certain criteria before prescribing. These could include patients who:

• Require insulin 
• Experience hypoglycemia (low blood sugars) without symptoms
• Struggle to control their blood sugars, and whose levels are either too high or too low

For those who struggle to maintain normal blood sugar levels, a CGM allows for your doctor to make adjustments to your medications and/or diet based on the trends seen on the CGM monitor. Research has shown CGM devices to have a positive impact on blood sugar control and HbA1C levels (a blood test that measures a person’s average blood sugar levels over the past three months). 

Does insurance cover CGM devices?

Whether you have private insurance, Medicare, or Medicaid, insurance coverages can change year to year. Fortunately, some insurances have made it easier to be approved for a CGM. 

For most people with private insurance, you will likely have some sort of copayment. Prices can vary depending on the brand of CGM, as well. If you notice that your insurance does not cover a CGM, consider switching plans during open enrollment (usually November through January) to a plan that does. 

Those with Medicare should have an easier time getting coverage than previously, as the four-time-daily fingerstick testing requirement was removed in July 2021. Other eligibility criteria still apply. You can learn more about eligibility through the Centers for Medicare and Medicaid Services (CMS) coverage database. 

For patients with Medicaid, CGM coverage is a bit more sporadic and varies state to state. If you have Medicaid, reach out to your state’s Medicaid program for coverage and eligibility requirements. 

No matter the type of insurance you have, speaking with your insurance provider can help provide clarity on CGM coverage, and what brand may be most affordable. 

*Farnsworth, C. (2022, February 8). What to know about continuous glucose monitors. Medical News Today. https://www.medicalnewstoday.com/articles/continuous-glucose-monitoring#definition

“2018.10.20 CGM Sensor Number 3, Washington, DC USA 06679.” by Ted Eytan is licensed by CC BY-SA 2.0