Expanding access to CGM in developing settings

Continuous glucose monitoring (CGM) is transforming how diabetes is managed – but for many families in lower-resource settings, it remains out of reach.

The technology tracks glucose levels continuously, providing real-time feedback and alerts. This allows individuals and caregivers to respond quickly to changes, reducing uncertainty and improving safety.

For children and their families, CGM can ease anxiety, particularly around low glucose levels during sleep or fasting. Yet despite its benefits, access remains limited in many parts of the world, where care still relies on basic, non-digital tools that offer only intermittent readings and little opportunity for remote clinical oversight.

CGM pilot programme

A pilot programme, now underway in Egypt with planned additional sites in Mexico and Moldova, addresses a critical gap: many children with type 1 diabetes lack access to the tools and supplies needed to prevent serious complications.

In this model, 20 children receive sensors alongside structured education and monthly follow-up from a trained nurse. The project also involves collaborating with non-physician partners, such as nurses and pharmacists, to support diabetes data interpretation and management.  The programme monitors outcomes before and after the intervention, including HbA1c levels, ICU admissions, and children’s and parents’ confidence.

It begins with an initial training session, followed by regular coaching. Over time, this supports safer insulin use while strengthening engagement between families and healthcare providers.

What outcomes are being measured

The programme tracks both clinical results and everyday experience. Changes in HbA1c and fasting glucose levels are used to assess improvements in control, while hospital admissions indicate severe complications such as diabetic ketoacidosis.

It also examines how families adapt to the technology. This includes acceptance, confidence in insulin adjustment, and concerns about low glucose episodes. Improvements in diabetes knowledge and self-management are also evaluated.

Taken together, these measures offer a more complete picture of both medical outcomes and quality of life.

Using local data to drive change

Locally generated data sits at the heart of the initiative. Findings from each site are compiled into reports for health authorities, highlighting outcomes within the community.

As Dr Andrew Behnke notes, “when they have local data that comes from their place, it is really powerful for change.” Evidence produced locally is often more persuasive for policymakers and supports more informed decisions about integrating CGM into standard care.

Addressing barriers beyond cost

Cost is often seen as the main barrier to access, but the project takes a broader view. In many settings, systems still rely on basic, non-digital tools that limit both patient support and clinical oversight.

Success in this programme depends on strong education and familiarity with CGM data. Before expanding its use more broadly, it is important to strengthen patient and provider education, understand cultural contexts, and ensure that systems are fully prepared to support implementation.

By building awareness, strengthening self-management skills and demonstrating clinical value, the programme aims to increase acceptance of digital monitoring. Over time, growing demand and wider use may help make access more sustainable through policy change and market competition.

Scaling the approach globally

The long-term aim is to expand the model across multiple locations, with a target of up to 50 sites supported by a dedicated funding pool. Current projects are largely charity-based, and future growth will depend on securing sustainable financial support.

As Dr Behnke puts it, “CGM will become standard care worldwide, and we can be a catalyst to support that.”

Monitoring will continue for 3 to 6 months, with reporting expected by mid-2026. If results are positive and funding becomes available, the model could be extended and adapted to additional regions.

What this means for people living with diabetes

For people with type 1 diabetes, particularly in resource-limited settings, access to CGM can significantly improve both health outcomes and quality of life. It supports better decision-making, reduces uncertainty and builds confidence for individuals and caregivers.

At a system level, the programme shows how targeted interventions can strengthen both individual care and healthcare delivery. Combining technology with education and local evidence offers a practical pathway towards more equitable and responsive diabetes care.

With sustained investment, policy support and collaboration, CGM could shift from a limited innovation to a standard component of diabetes care worldwide — narrowing one of the most persistent gaps in global health.