Section 7. Diabetes Technology
(https://doi.org/10.2337/dc23-S007)
The importance of “preference” for diabetes devices was added in all recommendations.
Recommendation 7.12 for the use of continuous glucose monitoring (CGM) in adults with diabetes treated with basal insulin was reworded to reflect updated evidence in the literature.
Recommendation 7.15 was modified to state that people with diabetes should have uninterrupted access to their supplies to minimize gaps in CGM use.
Recommendation 7.19 was added to address CGM interfering substances, with evidence level C.
A new paragraph addressing substances and factors affecting CGM accuracy was added to the “Continuous Glucose Monitoring Devices” subsection. Table 7.4 was added to address interfering substances for CGM.
Information was added on all three integrated CGM devices available, and it was specified that although there is more than one CGM system approved by the U.S. Food and Drug Administration (FDA) for use with automated insulin delivery systems, only one system with integrated CGM designation is FDA approved for use with automated insulin delivery systems.
Literature and information was added on benefits on glycemic outcomes of early initiation of real-time CGM in children and adults and the need to continue CGM use to maximize benefits.
The paragraph on connected pens was updated to include smart pen caps. References were updated for automated insulin delivery systems to include all the approved systems in the U.S. in 2022.
The text was updated to include do-it-yourself closed loop systems.
The “Inpatient Care” subsection was updated to include updated evidence and a paragraph on the use of CGM in the inpatient setting during the COVID-19 pandemic.