The Science of Diabetes Self-Management and Care 2025, Vol. 51(5) 447 –448 © The Author(s) 2025 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/26350106251366655 journals.sagepub.com/home/tde
Dear Editors:
We read with great interest the article titled “Intermittent Use of Continuous Glucose Monitoring in Type 2 Diabetes Is Preferred: A Qualitative Study of Patients’ Experiences” by Bendixen et al.1 This work compellingly illustrates the benefits of periodic use of continuous glucose monitoring (CGM) for improved self-management among individuals with type 2 diabetes mellitus (T2DM). These insights carry particular significance for India, which currently has one of the highest burdens of T2DM globally, estimated at over 100 million individuals.2
The Indian dietary pattern is uniquely predisposed to metabolic disturbances. Carbohydrate-dense staple meals, such as white rice, wheat, and deep-fried snacks, dominate everyday consumption. Further compounding this issue is the widespread cultural acceptance of overindulgence, or what might be termed gluttony, during festivals, family functions, and celebrations. This tendency spans all age groups and, unfortunately, is now being emulated by children and adolescents, thereby laying the groundwork for future generations of T2DM patients.3
In this context, intermittent use of CGM offers a highly relevant and pragmatic intervention. It can empower individuals by providing real-time biofeedback, helping them understand how specific foods and behaviors affect their glucose levels. Importantly, the visual immediacy of CGM data resonates across literacy levels, making it a powerful educational tool even in low-resource and low-literacy settings. Moreover, the utility of CGM can be stratified by age group in India:
Children and adolescents: With increasing availability of fast food, sugary beverages, and screen addiction, childhood obesity and early onset insulin resistance are rising sharply. Introducing continuous glucose monitors in school-based wellness programs or pediatric clinics even intermittently can offer a powerful visual lesson on how lifestyle choices influence long-term health.
Young adults: Among urban professionals and college students, erratic work schedules, sleep disturbances, and dietary negligence are common. CGM can help decode the glycemic consequences of these habits and foster accountability.
Middle-aged and elderly adults: For individuals managing long-standing T2DM or at high risk due to familial and lifestyle factors, CGM supports optimized treatment strategies, timely dietary corrections, and improved medication adherence. As Bendixen et al1 note, even short-term use can improve health-promoting micro-decisions.
From a policy standpoint, India’s flagship initiatives, such as Ayushman Bharat and the National Program for Prevention and Control of Non-Communicable Diseases, can integrate CGM technology within their framework. When used intermittently, continuous glucose monitors are not only cost-effective but also potentially more impactful than traditional finger-prick monitoring, which lacks real-time insight and often induces testing fatigue.4
The psychological benefits reported in the study, including enhanced health literacy, empowerment, and reduced distress, are particularly valuable in a society where diabetes is often managed passively or reactively. Furthermore, with rising out-of-pocket health care costs in India, an intermittent CGM model balances patient education with economic feasibility.
In summary, this study’s insights are not only globally relevant but also especially critical for a diverse, populous country like India. Intermittent continuous glucose monitor use offers a culturally adaptable, scalable, and evidence-based strategy to combat a growing public health crisis. It supports proactive self-care and, perhaps more importantly, reshapes deeply ingrained food behaviors in a society where “eating well” is often equated with “eating more.”
Thank you for publishing this impactful study. We hope your readership across the globe, including in resourceconstrained settings, considers the practical application of intermittent CGM as a bridge between clinical care and self-empowerment.
Keshavi Killi: Conceptualization, Writing - original draft; Aparna Kuna: Writing - review & editing; Dilip Kumar Kandar: Writing - review, editing, & validation.
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. All the authors have read and approved the manuscript, and they are aware of its submission.
The authors received no financial support for the preparation of this article.
Keshavi Killi https://orcid.org/0009-0001-6925-5955
Aparna Kuna https://orcid.org/0000-0002-3341-6227
Bendixen BE, Wilhelmsen-Langeland A, Lomborg K, et al. Intermittent use of continuous glucose monitoring in type 2 diabetes is preferred: a qualitative study of patients’ experiences. Sci Diabetes Self Manag Care. 2025;51(3):323-332. doi:10.1177/26350106251326517
Sun H, Saeedi P, Karuranga S, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. doi:10.1016/j.diabres.2021.109119
NCD Risk Factor Collaboration. Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature. 2019;569:260-264. doi:10.1038/s41586-019-1171-x
Williams DM, Parsons SN, Dunseath GJ, Stephens JW, Luzio SD, Owens DR. The impact of structured self-monitoring of blood glucose on glycemic variability in non-insulin treated type 2 diabetes: the SMBG study, a 12-month randomized controlled trial. Diabetes Meta Syndrome: Clin Res Reviews. 2020;14(2):101-106. doi:10.1016/j.dsx.2020.01.006
From Kandar Diabetes Centre, Tarnaka, Hyderabad, TG, India (Dr Killi, Dr Kandar); and Professor Jayashankar Telangana Agricultural University, Hyderabad, TG, India (Dr Kuna).
Corresponding Author: Keshavi Killi, Kandar Diabetes Centre, Tarnaka, Hyderabad, TG 500017, India. Email: dr.killikeshavi@gmail.com
