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CGM limitations

multicenter RCT (CONCEPTT), pregnant women and women planning a preg-
nancy with T1DM were randomized to adjunctive real-time CGM with capillary
glucose monitoring or capillary glucose monitoring alone [62]. The pregnant
CGM cohort reported more time in the target range, reduced glycemic variability,
and a minimal HbA1c reduction at 34 weeks gestation. In addition, neonatal
outcomes including large for gestational age, neonatal hypoglycemia, and admis-
sion to neonatal intensive care >24 h were all significantly reduced [62]. Glycemic
control outcomes revealed no HbA1c improvements in the women planning preg-
nancy; however, this cohort was not powered to identify significant changes seen in
the pregnancy cohort [62].

CGM quality of life data
An important aspect of managing chronic disease is understanding the impact both
the condition and the required long-term therapy have on an individual’s quality of
life. Self-monitoring the impact of daily activities on glycemia provides users with a
contextual understanding of how to modify their management to suit their lifestyle
and not vice versa. Applying the thematic analysis to semistructured interviews,
RT-CGM has been shown to enhance a sense of safety and control, while reducing
stress among a majority of T1DM participants at high risk of hypoglycemia [63].
However, a section of participants found CGM to be intrusive, frustrating, and serve
to remind us of the heterogeneous expectations of what is considered an improved
quality of life [63]. The subjective nature of these outcomes encourages further
investigation across varying diabetes populations.

CGM limitations

Despite the significant increase in CGM users over the last decade, SMBG remains
the universally accepted method for glucose monitoring for individuals with insulin-
requiring diabetes. Later we have outlined the factors limiting CGM uptake as a user,
physician, and device dependent.

User dependent
Similar to many chronic diseases, the daily experience of living with diabetes can
be extremely personal, and expectations can dynamically vary between individ-
uals. To successfully yield the proven benefits of CGM, healthcare professionals
must be insightful in identifying individuals that would struggle to apply the tech-
nology and those that would be resistant change and what it entails. Abandoning
well-served methods and adopting new practices can be frightening, and users
require the support of robust education programs to help facilitate the transition.
As established, forgetfulness is often cited as a reason behind SMBG noncompli-
ance. Frequent SMBG and blood glucose data analysis can be exhausting with