Thomas Martens, M.D., on how new evidence could shift payer coverage of CGM | ADA 2026

New evidence from the CONECT trial could eventually move payer coverage for continuous glucose monitoring (CGM) in type 2 diabetes not treated with insulin, but the process will be lengthy, Thomas Martens, M.D., of HealthPartners, told Managed Healthcare Executive after presenting the findings at the 2026 American Diabetes Association (ADA) Scientific Sessions.

Level A is the highest evidence rating the ADA assigns, reserved for findings from high-quality, reproducible, rigorously conducted randomized controlled trials, Martens explained. Weaker trials or observational data earn lower grades. As a rigorously conducted, randomized 283-participant trial, CONNECT should qualify, he said.

That grading matters because of how coverage decisions cascade. Compelling RCT data drive guideline committees, guidelines gradually shift, and payers tend to follow because they want the best available science behind what they reimburse, Martens said. Coverage typically expands first through Medicare, then commercial payers. He framed it as a multiyear process as the data, supported by observational evidence, reach guideline panels and then payers. Whether it plays out that way, "we will see," he said, but that is the typical path.

On replicating the trial's results, Martens pointed to the high, consistent CGM use throughout the study as a sign that patients found it useful. The key to onboarding, he said, is brief, practical education. Helping patients know their target, which is often a time-in-range goal, and teaching them to read the data on their smartphones, is key to ensuring uptake. Patients can see when a meal heavy in simple carbohydrates spikes glucose quickly and when less processed foods produce smaller rises and then adjust accordingly.

The devices are intuitive and approved for self-start, he noted, and skin reactions, while possible, are usually manageable. The larger challenge, he said, is using the data well. On the clinicians’ end, this means helping patients act on what they see and adjusting therapy, particularly as CGM scales into primary care.