Continuous Glucose Monitoring for Type 2 Diabetes in British Columbia: A Transformative Approach to Diabetes Care
- t2diabetesnetwork
- Oct 20
- 5 min read
Key Highlights
✅ CGMs track glucose in real time - no finger pricks needed.
✅ Shown to improve HbA1c, time in range, and quality of life.
✅ BC PharmaCare covers CGMs only for insulin users.
✅ Non-insulin users rely on private insurance or self-pay.
✅ Wider access could cut costs and boost self-management.
✅ Providers see CGMs as valuable for education and motivation.
In the evolving landscape of diabetes management, Continuous Glucose Monitoring (CGM) stands out as a pivotal advancement, particularly for individuals living with Type 2 Diabetes (T2D). Unlike traditional blood glucose meters that offer intermittent snapshots of glucose levels, CGMs provide real-time, continuous data, enabling both patients and healthcare providers to gain deeper insights into glucose fluctuations throughout the day and night.
What Is Continuous Glucose Monitoring?
A CGM system comprises a small sensor inserted under the skin, typically on the abdomen or upper arm, which measures glucose levels in the interstitial fluid. This sensor transmits data wirelessly to a receiver or smartphone app, displaying glucose trends and patterns. Modern CGMs, such as the Dexcom G6 and FreeStyle Libre 2, offer features like real-time alerts for high or low glucose levels, helping users take proactive steps to manage their condition. CGM Canada hosts a wealth of resources
The Clinical Utility of CGMs in T2D
CGMs aren’t just for people on insulin anymore. A recent Canadian review article (Aronson et al, June 2025) looked at how CGMs can help people with T2D who aren’t using insulin and found some pretty promising results. Unlike the traditional finger-prick tests, CGMs track glucose continuously, giving a fuller picture of blood sugar ups and downs. The review included eight studies with over 500 participants, about half of whom used a CGM.
The results? People using CGMs saw lower HbA1c levels, spent more time in their target glucose range, and had less time with high blood sugar. Beyond the numbers, CGMs also improved the overall experience for patients and even helped reduce healthcare visits and costs. In short, CGMs are showing real value for people with T2D, whether they’re on insulin or not, giving both patients and healthcare providers more tools to manage diabetes in everyday life.
Beyond glycemic control, CGMs have been associated with a decrease in hypoglycemic events and an increase in time spent within target glucose ranges. This continuous feedback loop empowers patients to make informed decisions about their diet, exercise, and medication, fostering a more active role in their diabetes management.
For individuals with T2D on intensive insulin therapy, CGMs have demonstrated significant benefits. Studies indicate that initiating real-time CGM in such patients can also lead to a reduction in HbA1c levels, a key marker of long-term blood glucose control. In another Canadian study assessing the cost effectiveness of CGMs in patients with T2D who were receiving insulin and are poorly controlled, CGM was found to be cost effective compared to self-monitoring blood glucose. So why the slow adoption?
Challenges in Adopting and Funding CGMs
Despite their advantages, the adoption of CGMs in T2D management is not without challenges. In 2021, British Columbia was the first province to cover Dexcom G6 Continuous Glucose Monitoring System for people with type 1 and type 2 diabetes on intensive insulin therapy. Of course, criteria and eligibility need to be met as well as a lengthy approval process, but what about those who weren't using insulin?
Currently, under BC Pharma Care, CGMs and flash glucose monitors (FGMs) are not routinely covered for people with T2D who are not on intensive insulin therapy. Here’s how the policy works, and why many non-insulin-treated T2D patients are currently not eligible under the publicly funded criteria.
PharmaCare lists CGMs/FGMs as a benefit if you meet these key eligibility requirements:
You are enrolled in one of the covered plans: Fair PharmaCare, Plan C (Income Assistance), Plan F (At Home Program), or Plan W (First Nations Health Benefits).
You have diabetes mellitus and meet the device-specific minimum age (e.g., 2+ yrs for CGM, 4+ for FGM)
Crucially: You require intensive insulin therapy (i.e., multiple daily insulin injections or insulin pump therapy) - this is explicitly stated as a condition.
You (or your caregiver) agree to comprehensive diabetes education and regular follow-up.
The device is deemed medically necessary, and the prescriber obtains a Special Authority (SA) request for coverage.
If you have T2D but are not on multiple daily injections of insulin or an insulin pump, then you typically do not meet the “intensive insulin therapy” criterion - and so you’re not eligible under the current PharmaCare CGM/FGM policy. You’ll likely need to rely on private insurance plans or paying out-of-pocket if you wish to use a CGM/FGM, because the provincial benefit doesn’t cover you under your current treatment regimen. It’s worth checking your extended health benefits or workplace insurance to see if your plan covers CGMs for non-insulin T2D.
The cost of CGM systems can be a significant barrier, as many devices and sensors are not covered under standard insurance plans. Even in provinces like British Columbia, where some coverage is available for individuals on intensive insulin therapy, the application process can be complex, and not all eligible individuals may be aware of the funding options.
Moreover, the influx of data from CGMs can lead to information overload for some users. Without proper education and support, patients may experience alert fatigue or become overwhelmed by the constant stream of glucose readings, potentially leading to underutilization of the device. So as part of the approval process, mandatory diabetes education is required.
Recognizing the importance of equitable access to diabetes management tools, in March 2025, Diabetes Canada advocated for expanded coverage and streamlined access to CGMs across the country. Their efforts aim to ensure that all individuals with T2D, regardless of socioeconomic status, have the opportunity to benefit from this technology.
Perspectives from Patients and Healthcare Providers
Patient Perspective: Many individuals with T2D report that CGMs have transformed their approach to managing their condition. The ability to monitor glucose levels in real-time allows for immediate corrective actions, reducing the frequency of hypoglycemic episodes and enhancing overall well-being. Patients also appreciate the convenience of reduced fingerstick testing, leading to less discomfort and a more seamless daily routine.
Healthcare Provider Perspective: Healthcare professionals recognize the value of CGMs in improving patient outcomes. CGMs provide clinicians with detailed data on glucose trends, enabling more precise adjustments to treatment plans. However, providers also emphasize the need for comprehensive patient education to ensure effective use of the technology and to mitigate potential challenges such as data overload.
The Future of CGMs in T2D Management
As technology continues to advance, the future of CGMs in T2D management looks promising. Emerging features like predictive alerts, integration with insulin pumps, and enhanced data analytics are poised to further personalize diabetes care. Additionally, ongoing research into expanding CGM access and affordability aims to make this technology accessible to a broader population, ensuring that more individuals with T2D can benefit from its advantages.
While challenges remain in the widespread adoption of CGMs for T2D, their potential to revolutionize diabetes management is undeniable. With continued advocacy, education, and support, CGMs can play a pivotal role in improving the lives of individuals living with T2D in British Columbia and beyond.
