Endocrine Society Applauds CMS on CGM Coverage

The Endocrine Society praised the decision to extend access to therapeutic continuous glucose monitors (CGMs) to older Americans on intensive insulin therapy for diabetes.

The Centers for Medicare & Medicaid Services (CMS) announced new coverage criteria for CGM devices Thursday. The guidance states that all Medicare individuals who have type 1 or type 2 diabetes and who use intensive insulin therapy can access therapeutic CGM devices (i.e. Dexcom G5) to monitor their blood glucose levels.

For many years, the Society has advocated to expand coverage for CGMs to the Medicare population. The Society is pleased with the new coverage criteria and looks forward to continuing work with CMS to ensure patients have access to these lifesaving tools.

In its Clinical Practice Guideline on diabetes technology issued in September 2016, the Society recommended CGMs as the gold standard of care for adults with type 1 diabetes. Continuous glucose monitors (CGMs) are primarily used to help in the management of type 1 diabetes, although the devices also can be useful for people with type 2 diabetes, particularly those at risk for severe hypoglycemia.
CGMs measure glucose levels in the fluid between the body’s cells every few minutes throughout the day and night. The technology can tell the user whether glucose levels are rising or falling, and monitor trends from the past several hours. The devices also feature alarms to warn users when glucose levels are too high or too low.

Studies of CGMs have shown that individuals with type 1 diabetes are able to maintain better control of their blood sugar without increasing episodes of hypoglycemia when blood glucose levels drop to dangerously low levels, compared to those who self-monitor blood glucose with periodic fingersticks.

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