Diabetes is one of South Africa’s fastest-growing health challenges, touching millions of households every day. For people living with the condition, continuous glucose monitors (CGMs) can mean the difference between stability and crisis — a technology that offers early warnings, safer treatment decisions and real independence.
But as CGMs become more visible and more widely used, a troubling reality is emerging: not all devices on the market are equally reliable. Cheaper, lightly tested products are increasingly being used alongside clinically proven technologies, raising serious concerns about patient safety, medical trust and health equity.
Now, South African diabetes advocacy organisations are stepping in — not only to expand access to CGMs, but to ensure that life-saving technology does not become a gamble.
A Technology That Saves Lives — When It Works
CGMs provide 24-hour glucose readings, reducing reliance on finger-prick testing and helping people avoid dangerous highs and lows. Used correctly, they can prevent medical emergencies, hospitalisations and long-term complications.
Yet families and clinicians are reporting growing uncertainty about which devices can be trusted.
“CGMs are incredible tools that remove guesswork from diabetes management,” says Kirsten de Klerk, Chairperson of SA Diabetes Advocacy. “But inaccurate devices can have life-threatening consequences — especially for children and insulin-dependent patients.”
Access as a Public-Health Issue
A coalition of organisations — including Sweet Life, Diabetes Alliance South Africa, Diabetes South Africa and Society for Endocrinology, Metabolism and Diabetes of South Africa — is pushing for CGMs to be recognised as essential medical care, not luxury lifestyle devices.
Their demands include:
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Making CGMs standard of care in the public healthcare system
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Ensuring private medical schemes fund CGMs as treatment, not add-ons
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Prioritising access for children under 18 living with diabetes
In November, a petition calling for CGM access for children was formally handed to the National Department of Health, supported by more than 9,000 South Africans.
The Hidden Safety Gap
As access efforts gain traction, advocates have identified a critical weakness: there are no global ISO or safety standards governing CGM accuracy. This leaves funders, procurement teams and clinicians without clear benchmarks when selecting devices — a gap that disproportionately affects lower-income patients who turn to cheaper alternatives.
To address this, South African organisations are jointly endorsing an evidence-based CGM accuracy checklist developed by the Foundation for Innovative New Diagnostics (FIND), in partnership with SA Diabetes Advocacy and the Institute for Diabetes Technology.
The checklist helps decision-makers distinguish between well-tested CGMs and devices that may pose real risks.
“As access grows, so does our responsibility to protect patients,” says Dr Patrick Ngassa Piotie, Chairperson of Diabetes Alliance South Africa. “Equity without safety is not progress. All CGMs must meet rigorous quality and performance standards.”
Why Accuracy Matters
Inaccurate CGMs can lead to incorrect insulin dosing and delayed treatment, triggering emergencies such as severe hypoglycaemia or diabetic ketoacidosis (DKA).
“Think of a CGM like a car,” says de Klerk. “You wouldn’t drive one that hadn’t been thoroughly tested across real-world conditions. A medical device should be no different.”
The checklist asks practical questions, including:
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Was the device tested on enough people with Type 1 or insulin-treated Type 2 diabetes?
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Was the study large and statistically reliable?
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Did testing cover the full sensor wear period?
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Were extreme highs, lows and rapid glucose changes included?
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Was the data independently peer-reviewed?
These criteria ensure CGMs perform accurately where it matters most — in daily life, not just controlled trials.
Progress Without Compromise
The coalition will now share the checklist with medical schemes, administrators and National Department of Health procurement teams. The message is clear: expanding access must never come at the cost of safety.
“We want more South Africans to benefit from CGMs,” de Klerk says. “But expansion must be responsible, evidence-based and patient-first.”
At a time when the healthcare system is under strain, this coordinated push represents practical, positive social impact — proving that access, equity and safety can move forward together.
People living with diabetes deserve both protection and progress — and South Africa’s advocacy sector is making sure they get both.
