Continuous Glucose Monitoring: A Practical Overview for Primary Care Providers in Canada

Authors

  • Sooyoun Shin, MD, FRCPC Division of Endocrinology & Metabolism, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON
  • Jeremy Gilbert, MD, FRCPC Division of Endocrinology and Metabolism, Department of Medicine, Sunnybrook Health Sciences; Centre and University of Toronto, Toronto, Canada

DOI:

https://doi.org/10.58931/cpct.2025.3349

Abstract

Continuous glucose monitoring (CGM) is transforming diabetes care, yet its use in type 2 diabetes (T2DM) remains underutilized in primary care. Given that most individuals with diabetes in Canada have T2DM and are managed primarily by primary care providers, the ability to interpret and apply CGM data is essential. This review provides an overview of CGM technology, key metrics, benefits and limitations, and offers practical tips for implementation in primary care.

Author Biographies

Sooyoun Shin, MD, FRCPC , Division of Endocrinology & Metabolism, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON

Dr. Sooyoun Shin completed her medical degree and core internal medicine residency at the University of Toronto, where she served as the Chief Medical Resident at Women’s College Hospital. She is currently completing her PGY 5 Adult Endocrinology residency at the University of Toronto. Dr. Shin has received multiple institutional awards for teaching and mentorship, including the F.M. Hill Mentoring Award. Clinically, she is committed to providing high‑quality, patient-centred care in her role as a future endocrinologist, where she aims to pair evidence-driven, compassionate care with pragmatic education for frontline clinicians and patients.

Jeremy Gilbert, MD, FRCPC, Division of Endocrinology and Metabolism, Department of Medicine, Sunnybrook Health Sciences; Centre and University of Toronto, Toronto, Canada

Dr. Jeremy Gilbert completed his medical degree, internal medicine training and endocrinology residency at the University of Toronto. He is an associate professor at the University of Toronto. He is the former program director for adult endocrinology and metabolism at the University of Toronto. He has authored a chapter in the 2013 and 2018 Diabetes Canada Guidelines and is a member of the steering committee of the Diabetes Canada Guidelines. He is the national lead for dissemination and implementation for the Diabetes Canada Guidelines. He is on the executive and is a national editor for the Canadian Journal of Diabetes. He is the endocrinology section chair at the Royal College of Physicians and Surgeons of Canada. He is a passionate teacher and his academic interest in undergraduate, postgraduate and continuing medical education in diabetes and endocrinology. He has received numerous awards for outstanding teaching including the 2021 Canadian Society of Endocrinology and Metabolism’s Harvey Guyda Educator of the Year Award. 

References

Public Health Agency of Canada. Diabetes in Canada: Facts and figures from a public health perspective. Ottawa: Government of Canada, 2011 [Internet]. [updated 04 July 2021, cited 20 August 2025] Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/diabetes-canada-facts-figures-a-public-health-perspective.html

Kirkwood J, Ton J, Korownyk CS, Kolber MR, Allan GM, Garrison S. Who provides chronic disease management? Population-based retrospective cohort study in Alberta. Can Fam Physician. 2023;69(6):e127-e133. doi:10.46747/cfp.6906e127

Teo E, Hassan N, Tam W, Koh S. Effectiveness of continuous glucose monitoring in maintaining glycaemic control among people with type 1 diabetes mellitus: a systematic review of randomised controlled trials and meta-analysis. Diabetologia. 2022;65(4):604–619. doi:10.1007/s00125-021-05648-4

Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kröger J, Weitgasser R. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet. 2016;388(10057):2254–2263. https://doi.org/10.1016/S0140-6736(16)31535-5

Elbalshy M, Haszard J, Smith H, Kuroko S, Galland B, Oliver N, et al. Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. Diabet Med. 2022;39(8):e14854. https://doi.org/10.1111/dme.1485

Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, et al. Clinical targets for continuous glucose monitoring data interpretation: International consensus on Time in Range. Diabetes Care. 2019;42(8):1593–1603. doi:10.2337/dci19-0028

Seidu S, Kunutsor SK, Ajjan RA, Choudhary P. Efficacy and safety of continuous glucose monitoring and intermittently scanned continuous glucose monitoring in patients with type 2 diabetes: a systematic review and meta-analysis of interventional evidence. Diabetes Care. 2024;47(1):169–179. https://doi.org/10.2337/dc23-1520

Uhl S, Choure A, Rouse B, Loblack A, Reaven P. Effectiveness of continuous glucose monitoring on metrics of glycemic control in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab. 2024;109(4):1119–1131. https://doi.org/10.1210/clinem/dgad652

Aronson R, Brown RE, Chu L, Bajaj HS, Khandwala H, Abitbol A, et al. Impact of flash glucose monitoring in people with type 2 diabetes inadequately controlled with non-insulin antihyperglycaemic therapy (IMMEDIATE): a randomized controlled trial. Diabetes Obes Metab. 2023;25(4):1024–1031. https://doi.org/10.1111/dom.14949

Lind N, Christensen MB, Hansen DL, Norgaard K. Comparing continuous glucose monitoring and blood glucose monitoring in adults with inadequately controlled, insulin-treated type 2 diabetes (Steno2tech Study): a 12-month, single-center, randomized controlled trial. Diabetes Care. 2024;47(5):881–889. https://doi.org/10.2337/dc23-2194

Wright EE, Roberts GJ, Chuang JS, Nabutovksy Y, Virdi N, Miller E. Initiating GLP-1 therapy in combination with FreeStyle Libre provides greater benefit compared with GLP-1 therapy alone. Diabetes Technol Ther. 2024;26(10):754–762. https://doi.org/10.1089/dia.2024.0015

Miller KM, Kanapka LG, Rickels MR, Ahmann AJ, Aleppo G, Ang L, et al. Benefit of continuous glucose monitoring in reducing hypoglycemia is sustained through 12 months of use among older adults with type 1 diabetes. Diabetes Technol Ther. 2022;24(6):424-434. https://doi.org/10.1089/dia.2021.0503

Natale P, Chen S, Chow CK, Cheung NW, Martinez-Martin D, Caillaud C, et al. Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies. J Diabetes. 2023;12:1048–1069. https://doi.org/10.1111/1753-0407.13454

Clark TL, Polonsky WH, Soriano EC. The potential impact of continuous glucose monitoring use on diabetes-related attitudes and behaviors in adults with type 2 diabetes: a qualitative investigation of the patient experience. Diabetes Technol Ther. 2024;26(10):700–708. https://doi.org/10.1089/dia.2023.0612

Diabetes Canada Clinical Practice Guidelines Expert Working Group, Cheng A, Feig D, Ho J, Siemens R; Diabetes Canada Clinical Practice Guidelines Steering Committee. Blood glucose monitoring in adults and children with diabetes: update 2021. Can J Diabetes. 2021;45(7):580–587. https://doi.org/10.1016/j.jcjd.2021.07.003

American Diabetes Association Professional Practice Committee . Erratum. 7. Diabetes Technology: Standards of Care in Diabetes-2025. Diabetes Care 2025;48(Suppl. 1):S146-S166. Diabetes Care. 2025;48(4):666. doi:10.2337/dc25-er04b

Messer LH, Berget C, Beatson C, Polsky S, Forlenza GP. Preserving skin integrity with chronic device use in diabetes. Diabetes Technol Ther. 2018;20(Suppl 2):S254–S264. https://doi.org/10.1089/dia.2018.0080

Brew-Sam N, Chhabra M, Parkinson A, Hannan K, Brown E, Pedley L, et al. Experiences of young people and their caregivers of using technology to manage type 1 diabetes mellitus: systematic literature review and narrative synthesis. JMIR Diabetes. 2021;6(1):e20973. https://doi.org/10.2196/20973

Abbott Laboratories. Freestyle Libre 14 day indications and important safety information [Internet]. Chicago: Abbott Laboratories; [cited 2025 Jul 15]. Available from: https://provider.myfreestyle.com/safety-information.html

Dexcom. Interfering substances and risks [Internet]. 2024 [cited 2025 Jul 15]. Available from: https://www.dexcom.com/interference

Published

2025-11-14

How to Cite

1.
Shin S, Gilbert J. Continuous Glucose Monitoring: A Practical Overview for Primary Care Providers in Canada. Can Prim Care Today [Internet]. 2025 Nov. 14 [cited 2025 Nov. 15];3(3):5–9. Available from: https://canadianprimarycaretoday.com/article/view/3-3-Shin_et_al

Issue

Section

Articles