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Reimagining type 2 diabetes care with CGM in primary care
Provided by AAFP partner
Primary care clinicians are uniquely positioned in diabetes management as they are often the first to guide patients through the whirlwind of a new type 2 diabetes (T2D) diagnosis. They help patients make sense of lab results, medications, and lifestyle changes. But one of the most transformative tools in diabetes care—continuous glucose monitoring (CGM)—has long been reserved for those on insulin. That’s changing. In fact, a new book, Clinical Decision Algorithms in Diabetes, supports CGM use in T2D as a first step to consider alongside lifestyle management and medication optimization.¹
In a landmark update earlier this year, the American Diabetes Association (ADA) recommended CGM not just for insulin users, but also for adults with type 2 diabetes who are on other glucose-lowering medications.² At the 2025 ADA Scientific Sessions, Dr. Richard Bergenstal delivered a message that should resonate across primary care:
“CGM isn’t just for insulin users anymore. It’s for everyone. And it’s time we start using it early.”
Seeing diabetes through a new lens
Picture a newly diagnosed patient—overwhelmed by numbers, unsure about food choices, and anxious about the future. Now imagine handing them a CGM and showing how their glucose responds to a brisk walk or a bowl of pasta. That’s not just data—it’s insight. It’s empowerment.
Dr. Bergenstal emphasized CGM’s role as a real-time feedback tool that helps patients connect their daily decisions to their glucose levels.
The research that backs it up
- In a 12-month, real-world study of 16,410 adults with T2D, CGM use was associated with significant improvements in glucose control in both non-insulin-treated and insulin-treated patients with T2D.³
- In another study, which looked at patients not on insulin or only on basal insulin in primary care, CGM was associated with an increased time in range (70-180 mg/dL) from 39.7%-61.9% (5.3 more hours per day) during the first 10 days of the unblinded period.⁴
- An analysis that included 12 randomized controlled trials (RCTs) found that CGM was associated with improved quality of life and treatment satisfaction, as well as a reduction in all-cause hospitalizations and acute events.⁵
Why primary care clinicians are key
Primary care teams are uniquely positioned to champion early CGM adoption. Their deep relationships with patients, holistic view of health, and role in long-term chronic care make them ideal advocates for this technology.
By integrating CGM into early diabetes care, primary care clinicians can help guide patients in taking a driver's seat in their health from day one—turning confusion into clarity and fear into confidence.
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REFERENCES
- Shah VN, Akturk HK. Diabetes Management. In: American Diabetes Association. Clinical Decision Algorithms in Diabetes. 2025: 1-45
- Diabetes Care. 2025;48(Supplement_1):S146–S166. doi.org/10.2337/dc25-S007
- Garg SK, Hirsch IB, Repetto E, et al. Glycemic Outcomes with CGM Use in Patients with Type 2 Diabetes—Real-World Analysis. Diabetes. 2024;73(Suppl 1):355–OR. doi:10.2337/db24-355-OR
- Shields S, Thomas R, Durham J, Moran J, Clary J, Ciemins EL. Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care. Sci Rep. 2024;14(1):31990. doi:10.1038/s41598-024-31990-0
- Ajjan RA, Battelino T, Cos X, et al. Continuous glucose monitoring for the routine care of type 2 diabetes mellitus. Nat Rev Endocrinol. 2024;20(7):426–440. doi:10.1038/s41574-024-00973-1
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