Case 1. A 27-year-old man has had type 1 diabetes for 19 years. His hemoglobin A_Ic level prior to starting RT-CGM [real-time continuous glucose monitoring] was 9.4%. . . . Over the 15 months of RT-CGM use, he was able to decrease his hemoglobin A_Ic level to 7.7% and maintain it at that level for several months. After he stopped using RT-CGM because his insurance didn’t cover sensors, his hemoglobin A_Ic level rose to 8.5%. When he got a new job and was able to resume use of RT-CGM, after three months his hemoglobin A_Ic level had once again decreased, this time to 7.9%.

Case 2. A 10-year-old girl has had type 1 diabetes for almost three years. Her hemoglobin A_Ic level before starting RT-CGM was 9.8%. By five months after starting RT-CGM her hemoglobin A_Ic level had decreased to 7.2%. After discontinuing sensor use because of the high cost of RT-CGM supplies and a lack of insurance coverage, her hemoglobin A_Ic level rose to 8.2%.

The above are composite cases of patients with type 1 diabetes who used real-time continuous glucose monitoring devices as a tool to improve their blood sugar control. They’re from an article in the April issue of AJN that gives a balanced overview of this technology, including how it works, its current uses (as a diagnostic tool, a warning system for hypo- and hyperglycemia, and a way to improve long-term glycemic control), its coverage and costs—and its advantages and disadvantages, […]