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Finding the right continuous glucose monitor (CGM) can be a challenge… Luckily, SA Diabetes Advocacy has developed a checklist to help us make informed decisions about our management tools with confidence.
With so many factors to think about when choosing a CGM, finding the right one can feel intimidating! One important thing to consider when deciding which CGM to use is accuracy – whether the sensor you’re choosing has gone through enough research and testing to provide you with the correct readings. We asked Kirsten de Klerk, chairperson of SA Diabetes Advocacy, all about the checklist.
What is the CGM Accuracy Checklist?
The CGM Accuracy Checklist is a set of questions that helps people with diabetes, healthcare professionals, and medical funders (medical aids) figure out how well a CGM has been tested and whether the readings are accurate enough to trust for everyday use.
As more CGMs become available in South Africa, we started noticing something important: not all CGMs are created equally.
Some devices give more reliable readings than others, and that can make a big difference when you’re using the numbers to make daily diabetes management decisions.
The problem is that, unlike fingerstick glucose meters, there still aren’t any ISO standards (a global quality management certification for medical devices) that all CGMs have to meet. So in practice, some CGMs can be sold without being properly tested in the same strict way as others and without proving, through strong independent evidence, that their readings are accurate enough for safe everyday use. So these questions are meant to be a practical tool people can use right now when deciding which CGMs they can trust when it comes to accuracy.
Ultimately, we want to make sure the diabetes community in South Africa has the information they need to make smarter, more informed choices about CGMs.
The checklist was created by diabetes advocacy organisations, including SA Diabetes Advocacy, together with technical experts from FIND (Foundation for Innovative New Diagnostics) and the Institute for Diabetes Technology (IfDT).
Why is it important?
CGM accuracy is important because the numbers on your CGM guide real-time diabetes decisions, such as insulin dosing or eating to prevent lows.
Inaccurate readings can be dangerous: If your CGM readings are not accurate, you could miss or wrongly treat dangerous glucose events, like very high or very low glucose levels. This can lead to diabetic ketoacidosis (DKA) or severe hypoglycaemia, both serious and potentially life-threatening if not managed in time.
Long-term diabetes management is affected: Over time, inaccurate readings can lead to glucose levels being out of the recommended range (between 3.9-10.0mmol/l) too often, which increases the risk of long-term complications like eye, kidney, or nerve problems.
Who is it for?
The checklist is intended for:
People living with diabetes who want to choose a reliable CGM.
Healthcare professionals helping people with diabetes select and use CGMs safely.
Medical funders evaluating which devices should be reimbursed.
Policymakers who make decisions about which CGMs are suitable for clinical use.
How does it work?
The checklist asks 6 key questions to check whether a CGM has been properly tested and can be trusted.
Who was it tested on?
(Was it tested on real people with diabetes who actually use CGMs?)
How many people were in the study?
(A small study isn’t enough to prove accuracy.)
Was it tested for the full wear time?
(If a sensor lasts 14 days, did they test accuracy across all 14 days?)
Was it tested in low and high glucose ranges?
(Accuracy matters most when glucose is dangerously low or very high.)
Was it tested during fast glucose changes?
(Real life with diabetes includes glucose spikes and drops, CGMs must keep up.)
Was the data checked independently?
(Not just “the company says it works”, but reviewed by outside experts.)
You can see a full explanation of the checklist questions alongside a car analogy here.
Where can people find out more?
You can read more about CGM accuracy and the 6-question guide on the SA Diabetes Advocacy website.
Follow SA Diabetes Advocacy on Facebook, Instagram and LinkedIn to keep up to date with their work.
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