Glucose Monitoring Should Fit the Patient, Not the Device

As glucose monitoring reaches more people with diabetes, the practical question for pharmacists is no longer which device is best, but which approach fits the patient in front of them. The American Diabetes Association (ADA) 2026 Standards of Care treat monitoring as an individualized decision, recommending that both blood glucose monitoring (BGM) and continuous glucose monitoring (CGM) devices be matched to a person's circumstances, preferences, and treatment.¹

According to Brooke Hudspeth, PharmD, associate dean of pharmacy practice at the University of Kentucky College of Pharmacy, the overall goal is to “develop a monitoring plan that is both clinically sound—clinically useful—and also manageable for the patient.” Such plans should be “something that a patient is actually going to be able to do and going to be able to use.”

Start With the Treatment Regimen

The ADA now recommends CGM for children, adolescents, and adults with diabetes on insulin therapy, on noninsulin therapies that can cause hypoglycemia, and on any diabetes treatment where CGM helps in management. The 2026 update positions CGM as an option from the time of diagnosis, not only for insulin users or those at high risk for hypoglycemia.^1,2

Coverage has not always kept pace; the Standards acknowledge that “insurance coverage can lag behind device availability.” Medicare’s CGM criteria, for example, require that a beneficiary be insulin-treated or have a documented history of problematic hypoglycemia, along with a qualifying practitioner visit within 6 months before the order.^1,3

For patients on noninsulin therapies, the ADA notes that BGM may be helpful when modifying meal plans, physical activity, or medications. When consistent CGM use is not feasible, the Standards suggest considering periodic personal or professional CGM to guide medication and lifestyle adjustments.¹

Where Fingerstick Testing Still Fits

Even for patients wearing a sensor, the ADA states that people using CGM devices must also have access to BGM at all times, including when CGM accuracy is in question, while a sensor warms up, and when CGM supplies are delayed. For patients taking insulin who use BGM, the Standards encourage checks when hypoglycemia is suspected, after treating low glucose until levels normalize, and before and during critical tasks such as driving.¹

Pharmacists also play a quality-control role. The ADA advises health care professionals to be aware of accuracy differences among meters, to use FDA-approved meters with unexpired and properly stored test strips purchased from a pharmacy or licensed distributor, and to consider potential interference from medications and other substances.¹

The Pharmacist's Vantage Point

Hudspeth said community pharmacists are well positioned to guide these decisions because "in many cases, the pharmacy is actually where they're getting their meter and their testing supplies in the first place."

Long-term relationships also matter. "We know their medications, we know their health history, and a lot of times we know many of the other factors—a lot of those social factors that truly affect their care—because we have those longstanding relationships with the patients we serve," she said. "What that does is really help us as their community pharmacists to individualize their monitoring."

That knowledge lets pharmacists work through the questions that shape a plan, Hudspeth said—when a particular patient should test, what the reading is meant to show, and what the patient will actually do with the information. Pharmacists can also be practical about supply access, daily schedules, and what is realistic for each person.

She cautioned against monitoring for its own sake. "BGM really shouldn't be just about collecting a bunch of numbers, right?" Hudspeth said. "Instead, we want to be able to help patients really understand those numbers and what they mean, and, ultimately, have the confidence to use those to effectively manage their diabetes."

REFERENCES

1. American Diabetes Association Professional Practice Committee for Diabetes. 7. Diabetes technology: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S150-S165. doi:10.2337/dc26-S007

2. Noridian Healthcare Solutions. Clinician checklist: continuous glucose monitors. Updated December 3, 2025. Accessed November 3, 2026. https://med.noridianmedicare.com/documents/2230703/16619307/Clinician+Checklist+Continuous+Glucose+Monitors.pdf

3. Halsey G. ADA publishes 2026 Standards of Care with updates to sections on technology, obesity, cardiometabolic disease management. Patient Care Online. December 9, 2025. Accessed November 3, 2026. https://www.patientcareonline.com/view/ada-publishes-2026-standards-of-care-with-updates-to-sections-on-technology-obesity-cardiometabolic-disease-management