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Evidence to Improve Care

Continuous Monitoring of Glucose for Type 1 Diabetes

Final Recommendation

  • Health Quality Ontario, under the guidance of the Ontario Health Technology Advisory Committee, recommends publicly funding continuous glucose monitoring in patients with type 1 diabetes who are willing to use continuous glucose monitoring for the vast majority of the time and who meet one or more of the following criteria:

    • Severe hypoglycemia without an obvious precipitant, despite optimized use of insulin therapy and conventional blood glucose monitoring

    • Inability to recognize, or communicate about, symptoms of hypoglycemia

Read the Full Recommendation Report

Insulin is produced by the body to help glucose (a source of energy) enter the body’s cells. Type 1 diabetes is a condition in which the body produces little or no insulin, leading to glucose buildup in the blood, which can cause serious damage. People with type 1 diabetes need to take insulin via injection or via an insulin pump, and monitor their blood glucose levels several times a day.

Continuous glucose monitoring involves the insertion of a small sensor under the skin to measure a person’s blood glucose levels every few minutes.

Diabetes is considered one of the most burdensome diseases for the health care system. The estimated number of people in Ontario who are living with type 1 diabetes varies widely, between 70,000 and 150,000. Type 1 diabetes affects people of all ages and genders, but is the most common type of diabetes in children and teenagers.

Our research review showed that adults with Type 1 diabetes who used continuous glucose monitoring stayed in their target glucose range slightly longer than those who used standard monitoring (finger pricks). However, it was uncertain if the duration of the studies was long enough to determine whether this additional time in target range had long term health benefits. In addition, many adult patients we spoke with who used continuous glucose monitoring said that they only used it periodically and used the standard method more often.

There has been very little patient satisfaction research conducted with children and with parents of children who use continuous glucose monitoring. But the parents of children we spoke with told us their anxiety about their children’s blood glucose levels and potential short and long term serious health effects was significant. They said that continuous glucose monitoring allowed for better blood sugar control and was effective in alerting them if intervention was needed.

The cost to the province to support those who are currently using this technology could be as low as $8.5 million over 5 years. To make it available for people who have no physical symptoms from low blood glucose events (who are often unaware that they are having an event), the cost would rise to $82.5 million over 5 years.

Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment (PDF)
February 2018

Related Resources

Continuous Glucose Monitoring for Patients With Diabetes: An Evidence-Based Analysis (PDF)
July 2011

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The Ministry of Health has accepted this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review Health Quality Ontario recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.

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