Continuous glucose monitoring based glycemic control among underserved populations with type 2 diabetes at a health system of federally qualified health centers

Background

Disparities and healthcare inequities exist among marginalized ethnic and racial groups with continuous glucose monitoring (CGM) use. Current evidence surrounding the impact of CGM use on hemoglobin A1C (HbA1c) reduction beyond 6 months among underserved populations, including non-English speakers with type 2 diabetes in the Federally Qualified Health Center (FQHC) setting, is limited.

Objective

To evaluate the impact of CGM use on the first HbA1c measured between 12 and 24 months after CGM initiation among underserved populations with type 2 diabetes at a health system of FQHCs.

Methods

A retrospective, cross-sectional study was conducted among adults with type 2 diabetes participating in a FQHCs’ CGM program. Patients were eligible if they received CGM supplies between July 2020 to 2022 at an in-house pharmacy via indigent care coverage and had an HbA1c more than 8% within three months prior to CGM initiation. The primary outcome was the impact of CGM use on the first HbA1c measured between 12 and 24 months after CGM initiation. A post-hoc analysis was conducted to assess the change in HbA1c from baseline over time, in 6-month increments, up to 24 months. Descriptive and bivariate statistics were used for data analysis.

Results

Of 205 patients who were initially screened, 46 met study inclusion criteria. Baseline characteristics included 65% female, mean age 56 ± 11.2 years, 76% Hispanic/Latino/a ethnicity, and 54% Spanish-speaking. The primary outcome resulted in a statistically significant decrease in HbA1c (%) from 10.6 ± 1.7 at baseline to 8.6 ± 1.9 (P < 0.001) at the follow-up HbA1c measured between 12 and 24 months after CGM initiation.

Conclusion

In this analysis, CGM use led to a statistically significant and sustained reduction in HbA1c for up to 24 months among underserved populations with type 2 diabetes in the FQHC setting. Study findings suggest CGM use may offer long-term benefits in HbA1c reduction among underserved populations.