U.K. consensus statement targets potential barriers to CGM use

Primary care professionals with expertise in continuous glucose monitoring (CGM) identified barriers to its application in the management of people with type 2 diabetes in a recent U.K. consensus statement.

The experts reviewed the reality of primary care clinical management of people with diabetes on nonintensive insulin therapy, with an emphasis on the use of CGM, including conducting a survey of primary care clinicians, and published a consensus statement on Dec. 15, 2024, in Diabetic Medicine. Abbott Diabetes Care organized the discussion panels and funded research but had no editorial input into the deliberations of the working group or the development of the manuscript.

The consensus statements include the following:

1. 1. Comprehensive training programs focused on the use and interpretation of CGM data should be implemented for primary care teams.
2. 2. Facilities and clinicians should proactively develop and deploy patient management systems that effectively integrate CGM data into electronic health records.
3. 3. Primary care teams must be able to use CGM technology to support timely treatment intensification and reduce therapeutic inertia.

In the survey of primary care clinicians, 42.9% said skills development in management of diabetes was among their higher priorities (ranked 1 or 2), whereas 54.3% believed it was the lowest priority, the statement reported. “This split may reflect the opinion among more-expert practitioners that management of people with diabetes is an established part of clinical care for many practices, but that targets for glycaemic control can be hard to meet,” the consensus statement said.

Almost all respondents agreed or strongly agreed that using CGM supports better decision making (94.3%) and can reduce therapeutic inertia in meeting glycemic goals (97.14%). Remote monitoring was seen as an important benefit of using CGM (94.3%), and 88.6% agreed that CGM technology provides an opportunity to improve clinical workflows in primary care. However, 65.7% of respondents said that making changes to clinical workflows to incorporate CGM technology was a potential barrier. A barrier expressed by 71.4% of survey participants was the potential for resistance to change within primary care teams. Lack of experience in using and interpreting CGM was another significant potential barrier (82.9%), as was providing education for people starting on CGM (65.7%).

The consensus statement discussed the role of CGM in reducing therapeutic inertia in diabetes management, highlighting the need for consensus targets for CGM metrics that are clear, understandable, and actionable to provide a strong framework for clinical decision making in primary care.

The need to adapt to the management of people with diabetes on insulin therapy puts significant pressure on current workflows and skills for primary care teams, according to the consensus statement. Steps to overcome these immediate pressures and ensure effective clinical management of people with diabetes were also discussed.

“Ultimately, the great majority of expert primary care [health care providers] were confident or very confident that using CGM technology will become the standard of care for people with [type 2 diabetes] treated with insulin in primary care,” the authors wrote.