John Anderson, MD, is an internal medicine and diabetes specialist at the Frist Clinic and past president of Medicine & Science for the American Diabetes Association (ADA).

John Anderson, MD

Continuous Glucose Monitoring in Type 2 Diabetes, With John Anderson, MD

Continuous glucose monitoring (CGM), initially developed for 

, has transformed the treatment landscape for 

 as well, both clinically and behaviorally.

CGM devices provide real-time glucose responses to daily meals and behaviors, encouraging patients to make and sustain behavior changes to improve their symptoms. By facilitating personalized self-management and significant behavior and clinical benefits for patients, CGM has established itself as a cornerstone of diabetes therapy.

“CGM has changed the management of type 2 diabetes, at least in a subset of the population, in very profound ways,” John Anderson, MD, an internal medicine and diabetes specialist at the Frist Clinic and past president of Medicine & Science for the American Diabetes Association (ADA), told 

 in an exclusive interview. “Patients have behavior changes as part of their CGM. They change their eating patterns, they exercise more. I’ve had several patients who think it’s the best thing they’ve ever had.”

Numerous randomized and real-world studies of CGM have shown its capacity for improving glycosylated hemoglobin, increasing time in range, and reducing glycemic variability, irrespective of the patient’s insulin use. Additionally, CGM has historically enhanced treatment satisfaction, psychological well-being, and self-efficacy. CGM also flags unrecognized glucose exertions beyond what conventional monitoring can reliably notice, allowing for earlier intervention in potential dysglycemia.

Given these clinical and real-world findings, the recent 2026 ADA Standards of Care in Diabetes guidelines actively recommend the use of CGM in patients with T2D on insulin therapy. Data sourced for the guidelines indicated substantial improvements both early and late in trial duration in A1C levels. Additionally, the guideline notes that the use of professional CGM in patients who were not on insulin reduces A1C, according to recent studies.

However, real-world implementation barriers, including cost, limited insurance coverage, and ongoing difficulties in translating data into actionable insights, are still preventing some patients from accessing this technology. Patients in low-income and rural settings exhibit the highest rates of these barriers. Additionally, a recent study has shown that a significant proportion of patients do not have a discussion with their clinicians regarding CGM use. This is attributed in large part to factors contributing to the insurance coverage and clinical utility of CGM. However, therapeutic inertia was also cited as a major driver.

Anderson also discusses recent technological advancements in CGM devices, including integration with insulin pumps and automatic insulin delivery (AID) systems to optimize medication delivery and HbA1c monitoring for patients with T1D and T2D.

“I think the technology is getting closer to where these pumps and the CGMs will communicate and learn together,” Anderson said. “You’ll never truly have an artificial pancreas, but you can get as close to a closed loop system as you can.”

Editors’ Note: Anderson reports disclosures with Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, and others.

Son H, Moon SJ, Cho YM. The Expanding Role of Continuous Glucose Monitoring in the Management and Prevention of Type 2 Diabetes. Diabetes Ther. 2026;17(2):201-216. 

Bajaj M, McCoy RG, Balapattabi K, et al. 7. diabetes technology: Standards of care in diabetes—2026. Diabetes Care. 2025;49(Supplement_1). 

Argueta AS, Ng JM, Zupa MF. Barriers to use of continuous glucose monitoring among adults with type 2 diabetes. Diabetes Research and Clinical Practice. 2026;235:113217. 

Videos

Anderson discusses recent advancements in CGM technology, as well as the myriad behavioral and clinical benefits of CGM use in T2D with or without insulin.

Addressing Potential Barriers to Implementing Hypercortisolism Screening in Practice

Video content above is prompted by the following:

What are some potential barriers to screening for hypercortisolism in primary and specialty care settings?

What are some ways to address and overcome these barriers?

When should a patient be referred to endocrinology after hypercortisolism screening?

How can primary care clinicians and specialists collaborate effectively to identify, screen, and refer patients with hypercortisolism in a timely manner to optimize patient care?

Experts discuss potential barriers to screening for hypercortisolism in primary care and specialty settings, ways to address these barriers, when a patient should be referred to endocrinology after screening, and how primary care clinicians and specialists can collaborate effectively to identify, screen, and refer patients with hypercortisolism to optimize patient care.

Importance of Multispecialty Communication in Hypercortisolism Management and Referrals

What is the role of primary care clinicians in identifying and screening patients for hypercortisolism?

How does hypercortisolism affect mental health? How can primary care clinicians help identify patients with mental health conditions who might be at risk for hypercortisolism?

How does hypercortisolism contribute to osteoporosis and an increased risk of fractures?

Experts discuss the role of primary care clinicians in identifying and screening patients for hypercortisolism, how hypercortisolism affects mental health and how primary care clinicians can identify at-risk patients, and how hypercortisolism contributes to osteoporosis and an increased risk of fractures.

Effect of Hypercortisolism on Cardiovascular and Diabetes Care

How does hypercortisolism contribute to treatment-resistant hypertension and other cardiovascular diseases?

We have mentioned that there are cardiovascular risks associated with hypercortisolism. How does treatment of hypercortisolism impact these risks?

Looking specifically from a cardiology perspective, when should a cardiologist suspect hypercortisolism as a contributing factor to cardiovascular disease?

What is the role of hypercortisolism in type 2 diabetes?

How does hypercortisolism complicate the management of type 2 diabetes, and how does it impact long-term glucose control?

Now, let us shift to the endocrinology perspective. When should an endocrinologist suspect hypercortisolism in their patients with type 2 diabetes?

Experts discuss how hypercortisolism contributes to treatment-resistant hypertension and other cardiovascular diseases, the impact of treating hypercortisolism on cardiovascular risks, when cardiologists should suspect hypercortisolism as a contributing factor to cardiovascular disease, the role of hypercortisolism in type 2 diabetes, how it complicates the management of type 2 diabetes and impacts long-term glucose control, and when endocrinologists should suspect hypercortisolism in their patients with type 2 diabetes.

John Anderson, MD

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