Marielle Tavares, DNP, MSN, PHN, NP-C, FNP-BC

Abstract:

Background: Continuous glucose monitors (CGMs) are associated with improved HgA1C and quality of life but have historically been less accessible to underserved populations. The 2022 changes to California Medicaid switched CGM coverage from Durable Medical Equipment to expanded pharmacy benefits which increased CGM access for Medi-Cal beneficiaries with Type 2 Diabetes (T2DM). These reimbursement changes necessitate opportunities to support CGM use among the Latinx population, which is significantly impacted by T2DM and remains disproportionately underserved and understudied. Objectives: To evaluate the effectiveness of a CGM educational intervention on diabetes empowerment, CGM adherence, diabetes distress, glucose monitoring satisfaction, and blood glucose regulation for Latinx adults with T2DM who have been prescribed a CGM. Methods: Participants for this pilot study were recruited at a Federally Qualified Health Center in Southern California from a primary interprofessional research study focused on patient outcomes of CGM use within underserved populations. Inclusion criteria included Spanish-speaking Latinx adults (18 years and older) diagnosed with T2DM who were prescribed a CGM. Ten participants agreed to attend a Spanish-speaking, in-person educational intervention with enhanced telephonic follow-up. The Diabetes Empowerment Scale Short Form (DES-SF) measured diabetes empowerment and was administered pre-intervention, immediately post-intervention, and six weeks post-intervention. CGM adherence and blood glucose regulation were measured by the CGM device and collected pre-intervention and six weeks post-intervention. Glucose-monitoring satisfaction scores and diabetes distress scores were administered pre-intervention and six weeks post-intervention. Results: Statistical significance was observed post-intervention in glucose monitoring satisfaction and CGM adherence. CGM adherence increased by 80%, and blood glucose control results varied one month after the intervention. Improvements were also demonstrated in diabetes distress and diabetes empowerment, although not statistically significant. The need for language-concordant health education and interventions focused on supporting Latinx adults with T2DM should continue to be explored. Conclusion: An educational intervention on CGMs, problem-solving barriers to CGM use, and diabetes empowerment in Latinx adults with T2DM provides preliminary data on the potential for improving CGM adherence, diabetes empowerment, and glucose monitoring satisfaction while decreasing diabetes distress. Further research on a larger sample is necessary.

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