CGM-Guided Insulin Initiation and Titration in Type 2 Diabetes

Managing type 2 diabetes can change over time, but having the right information for your patients can make those changes feel a lot more manageable. CGM can help your patients see what’s happening with their blood sugar and guide what comes next.

In this episode of the TCOYD Podcast, Dr. Steve Edelman and Dr. Jeremy Pettus discuss how continuous glucose monitoring is changing the way type 2 diabetes is managed for your patients, especially as treatment needs evolve over time. They explain why type 2 diabetes can progress from lifestyle changes and oral medications to GLP-1 therapies and insulin, and why needing insulin isn’t a personal failure. They also explore how seeing glucose data in real time can help your patients better understand how meals, exercise, medications, and insulin affect their glucose throughout the day.
The conversation gets practical with how CGM can help guide your patients’ transition to basal insulin, make insulin adjustments easier and safer, and identify when mealtime insulin may be needed. Dr. Edelman and Dr. Pettus explain what overnight glucose patterns can tell you about your patients’ basal insulin dose, how to recognize post-meal spikes, and why starting mealtime insulin doesn’t necessarily mean adding injections at every meal for your patients. They also discuss newer basal insulins, avoiding too much basal insulin, and how automated insulin delivery systems may fit into the future of type 2 diabetes management.
Ultimately, CGM gives your patients living with type 2 diabetes more than glucose numbers. It provides feedback that can help them recognize patterns, see how their treatment is working, and work with their healthcare team to make more informed adjustments as their diabetes management needs change.

Key Topics:

• Why type 2 diabetes treatment needs can change over time
• How insulin resistance and declining insulin production affect glucose management
• Why needing insulin is not a personal failure
• How CGM use is expanding in type 2 diabetes
• Using CGM with lifestyle changes, oral medications, GLP-1 therapies, and insulin
• What time in range, GMI, and glucose variability can tell you
• How CGM can help determine when basal insulin may be needed
• Using overnight glucose patterns to adjust basal insulin
• Why insulin titration matters more than the initial starting dose
• How CGM can make insulin adjustments easier and safer
• When mealtime insulin may be needed
• Why mealtime insulin doesn’t always have to be taken with every meal
• How to recognize and avoid too much basal insulin
• The benefits of newer long-acting basal insulins
• When patients with type 2 diabetes may want to consider an insulin pump or automated insulin delivery system
• How real-time glucose feedback can help people take a more active role in their diabetes management

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