What CGM Data Features Pharmacists Overlook—and How They Can Help Patients Use Them

In an interview with Pharmacy Times, Amy Hess-Fischl, MS, RDN, LDN, BC-ADM, CDCES, quality coordinator in the department of adult and pediatric endocrinology at Kovler Diabetes Center, discussed key topics covered at the 2026 Diabetes Day of Education, urging pharmacists to take advantage of underutilized continuous glucose monitoring (CGM) app features—particularly glucose management indicator (GMI) and time in range—to help patients feel informed and confident before their clinical visits.

When reviewing an ambulatory glucose profile (AGP) report, Hess-Fischl emphasized the importance of first confirming adequate wear time (at least 14 days and greater than 70% usage), then prioritizing hypoglycemia as the most critical pattern to address given its high mortality risk, followed by identifying postmeal glucose spikes that may warrant changes in medication timing or dosing. She identified lack of patient awareness and empowerment as the biggest real-world barrier to long-term CGM persistence, noting that many patients are told to wear devices without receiving meaningful guidance on how to use them effectively. Hess-Fischl called on pharmacists to connect patients with diabetes self-management education and support (DSMES), reminding them that two hours of DSMES per year is a covered benefit and to offer flexible CGM use options that fit individual patient lifestyles.

Pharmacy Times: What are the most underutilized data features in today’s CGM apps that pharmacists should be paying closer attention to?

Amy Hess-Fischl, MS, RDN, LDN, BC-ADM, CDCES: There are so many, but I think the most important thing is for pharmacists to understand that a lot of these features are embedded in the app that the patient already sees. Being able to view the glucose management indicator (GMI)—which provides an estimated average A1c—is such a helpful way for patients to understand where they stand. I have so many patients come in and say they were afraid to come in because they really did not know how they had been doing. Patients have access to that app, and so having the pharmacist say, “Take a look at your time in range; take a look at your GMI,” can help them feel more comfortable and confident going into their doctor, nurse practitioner, or PA visit. It gives them the ability to say, “This is where I need to be, this is where I am—how can I get there?”

Pharmacy Times: When reviewing an ambulatory glucose profile report, what are the 2 or 3 patterns that immediately signal a treatment regimen needs to be adjusted?

Hess-Fischl: Before even looking at the data, there are two things we want to confirm: how long the patient has been wearing the device and their percentage of usage, because without sufficient data, the information will not be as meaningful. We want to make sure they have been wearing it for at least 14 days and for greater than 70% of the time. Once that is established, the first thing we want to focus on is lowes. Unfortunately, severe hypoglycemia carries a high mortality rate, so that is always the priority. After that, we want to look at where the rises are happening—where those spikes occur. Even just focusing on those two areas can guide treatment: if we are seeing more lows, we make a treatment change; if we are seeing postmeal spikes, we discuss timing, doses, and whether the patient is dosing at all.

Pharmacy Times: What are the biggest real-world barriers preventing people with diabetes from achieving long-term CGM persistence?

Hess-Fischl: I will offer a shameless plug as a diabetes care and education specialist here: one of the biggest barriers I see is that patients simply are not aware of how to use CGMs, and they are not empowered to do so. They are told by their provider that they have to wear it without being given much insight into how to use it effectively. That is where DSMES comes in—we know that two hours of diabetes self-management education and support per year is a covered benefit, and connecting patients with a diabetes care and education specialist allows for individualized guidance on using the technology appropriately. I also find that some patients tell me they just do not want to wear it all the time, and many do not realize they have options—for example, wearing it for two weeks once every couple of months. Giving patients options that fit within their lifestyle makes a significant difference in long-term persistence.