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2023 ADA Guidelines Recommend rtCGM for Improved Diabetes Management

Published on: 1 June 2023

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The American Diabetes Association® (ADA) recently published its Standards of Care in Diabetes—2023 evidence-based guidelines for preventing, diagnosing, and treating diabetes.1

The guidelines recommend that real-time continuous glucose monitoring (rtCGM) devices, like the Dexcom G6 rtCGM System, should be used for glucose management in adults with diabetes on basal insulin. National healthcare programs are following suit and expanding coverage to include rtCGM devices.

ADA Standards Updated Based on New Evidence

The ADA Standards of Care in Diabetes guidelines previously made the following recommendation: 

“Real-time continuous glucose monitoring (rtCGM) or intermittently-scanned continuous glucose monitoring (isCGM) can be used for diabetes management in adults with diabetes on basal insulin who are capable of using devices safely (either by themselves or with a caregiver). The choice of device should be made based on patient circumstances, desires, and needs.”

The 2023 guidelines were updated to reflect clinical evidence published last year. Recommendation 7.12 now states rtCGM (level of evidence A) and isCGM (level of evidence C) “should be offered” for diabetes management in adults with diabetes on basal insulin. 

The switch from “can” to “should” illustrates the undeniable benefits of continuous glucose monitoring systems. The assigned ‘A’ rating to rtCGM further shows that these benefits are more strongly supported in rtCGM than with isCGM (‘C’ rating). Clinical trials and real-world results have shown that rtCGM technologies like Dexcom G6 can significantly improve A1C, time in range (TIR), and glucose variability.2

CMS Expands rtCGM Coverage in the US

Shortly after ADA published its 2023 guidelines, the Centers for Medicare and Medicaid Services (CMS) rolled out the largest expansion of rtCGM coverage to date. 

The expanded coverage includes people with type 2 diabetes (T2D) on insulin and people who are not on insulin but have a history of hypoglycemia. It’s estimated that up to 2 million Americans will benefit from the policy change.3 

Canada is Making Similar Changes to Coverage

Diabetes Canada’s Reimbursement of Intermittently-Scanned and Real-Time Continuous Glucose Monitoring Systems policy position recommends that access to rtCGM systems should be extended to all Canadians who could benefit positively from the technology in their diabetes management. This includes adults, adolescents, and children living with diabetes. 

Public healthcare programs in Canada are responding to these recommendations and expanding coverage to include rtCGM technology. The province of Manitoba recently updated its public coverage to include the Dexcom G6 rtCGM System for people living with T1D or T2D.

Dexcom G6 coverage on the Non-Insured Health Benefits (NIHB) program has also been expanded to include all eligible First Nations and Inuit peoples living with type 1 diabetes. This expansion aligns with the ADA standards of care. 

Details on Dexcom G6 coverage across Canada can be found here.

Dexcom G6 is Covered for More People Than Ever

As more clinical studies demonstrate the benefits of rtCGM use and diabetes advocates, like the ADA and Diabetes Canada, recommend it as a standard of care, there is growing interest in expanding public and private coverage. Increased access to Dexcom G6 means more people can feel empowered to better manage their diabetes. 

Read the 2023 ADA update

1 American Diabetes Association. Standards of Care in Diabetes. Diabetes Care. 2023;46(Supp 1):S1-S291.
2 Brown R, et al. Diabetic Medicine. 2022;39(11):e14937.
3 Chen S. Medicare expands CGM coverage for people with type 2 diabetes. diaTribe. Published March 3, 2023. Updated April 17, 2023. Accessed April 24, 2023.

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