Advancing Primary Care: Continuous Glucose Monitoring in Type 2 Diabetes Management

Abstract

Background: CGM technology provides accurate, real-time glucose data, improving glycemic control, reducing glycosylated hemoglobin (HbA1c), and enhancing patient engagement. Despite evidence-based recommendations, CGM remains underutilized in primary care, often due to limited provider familiarity with prescribing and educating patients on device use. Barries include knowledge gaps, time constraints, and uncertainty regarding insurance coverage. Providers at this primary care clinic identified a knowledge gap but have interest in CGM utilization for their T2DM patients. Purpose: The purpose of this DNP quality improvement project was to increase healthcare provider (HCP) knowledge, confidence, and intended implementation of continuous glucose monitoring (CGM) in adults with type 2 diabetes mellitus (T2DM) and to identify additional learning needs at a Southwest, urban primary care clinic. Methods: Using the Chronic Care Model (CCM) and the Plan-Do-Study-Act (PDSA) framework, an approximately 15-minute asynchronous, online educational session was delivered via email to providers at a Southwest, urban primary care clinic. The presentation covered American Diabetes Association (ADA) aligned pharmacotherapy, CGM metrics, device selection, and patient education. An online, anonymous post-intervention survey was utilized to assess changes in knowledge, confidence, and intent to implement CGM, and identified future learning needs to facilitate utilization. Results: Of the five eligible providers, four (80%) completed the asynchronous, online presentation and post-intervention survey. All respondents had selected they had prior experience with CGM, and four (100%) respondents reported increased knowledge and confidence in educating patients about CGM use and prescribing CGM for appropriate adults T2DM patients. Three (75%) respondents selected that they intended to prescribe more CGM after viewing the presentation and one (25%) responded selected they were neutral. Barriers identified included insurance coverage, data interpretation, and time. Facilitators identified included the asynchronous nature of the presentation and information gained from the presentation. Conclusions: This quality improvement project effectively improved provider knowledge, confidence, and intent to prescribe CGM for appropriate T2DM patients at a Southwest urban primary care clinic. The findings of this QI project align with existing literature, especially the barriers and facilitators, investigating CGM use in the primary care setting. Recommendations for further projects include targeting education for insurance coverage and CGM data interpretation while keeping the asynchronous nature of the presentations.