CGM Adoption in Primary Care: "We're Lagging Behind Standards of Care"

"We still have a lot of education [to do] about how to interpret an ambulatory glucose profile...we've got a ways to go."

John E Anderson, MD, an internist at the Frist Clinic in Nashville, TN, where he focuses on diabetes management, described the history of continuous glucose monitoring (CGM) in a recent interview with Patient Care,© as evolving from clumsy, uncomfortable devices requiring frequent finger sticks to painless, highly accurate sensors that provide real-time data. Anderson pointed to the transformation in diabetes management ushered in by the Dexcom G6/G7 and Abbott FreeStyle Libre CGMs, but continued with the caveat that primary care clinicians, who treat the majority of people with type 2 diabetes, aren't adopting the technology as quickly as they could.

Patient Care spoke with Anderson during the 2025 Family Medicine Experience (FMX) conference in Anaheim, CA, October 5-9, 2025, about the evolution of CGM technology, why adoption has been slow, and what's holding clinicians back from effectively interpreting ambulatory glucose profiles. He says he still hears a lot of "I'm not familiar with [CGM]," and "I'm not sure how to interpret the data." So, he stressed, the barrier isn't really the technology itself—it's simply unfamiliarity with reading the data. He also highlights another demonstration of lag, and that is the gap between patient demand and physician comfort with the technology.

The following transcript has been lightly edited for flow and style.

Patient Care: I want to first talk about the evolution of continuous glucose monitoring over the last 10 to 15 years, and how it's actually impacting clinical outcomes.

John E Anderson, MD: It's a great question. Glucose monitoring started with blood glucose finger sticks, and even before that, urine test strips. Our patients trying to do blood glucose finger sticks, if you're on an intensive insulin regimen, four to six times a day minimum. Then we started to have an evolution of fairly clumsy continuous glucose monitors. Then we had better, more sophisticated monitors, but they still required needle sticks and were uncomfortable for patients. And then we got to where these sensors became painless, easily applied and extraordinarily accurate. The two on the market really, in addition to the MiniMed sensor for its pump, are the Dexcom G6 and G7 currently, as well as the Abbott FreeStyle Libre.

Patient Care: What is your assessment of how family and other primary care clinicians are currently integrating CGM into routine diabetes care?

Anderson: We're really lagging behind the standards of care. Primary care manages 90% of the type two diabetes in this country, and I would say we're lagging behind. It's being adopted because there's also a lot of patient demand for it. When primary care clinicians are seeing the success rate of behavior modification and change, they're adopting it. But we had a program last night, and there's still this "I'm not familiar with it. I'm not sure how to interpret the data." So we still have a lot of education needed about how to interpret an ambulatory glucose profile, or an AGP, which is a standardized glucose profile to look at the highs and the lows and where the danger points are and how to improve therapy. We've got a ways to go.