Bol, T, Odugbesan, O, Wright, T, Rioles, N, Fantasia, K, Zupa, M, Haw, S, Ebekozien, O.

Introduction and Objective: Most published studies have demonstrated the value of continuous glucose monitors (CGM) in type 1 diabetes. Type 2 diabetes involves more varied management approaches, ranging from oral medications to insulin therapy. Significant disparities exist in CGM adoption among people with type 2 diabetes (PwT2D). Non-Hispanic Black and Hispanic PwT2D, those with lower household income, or public insurance, are less likely to be on a CGM. The aim of this study is to highlight strategies that effectively increase CGM adoption equitably.

Methods: Three centers in the T1D Exchange Quality Improvement Collaborative used the 10-step equity framework, including the Ishikawa diagram, process map, effort/impact matrix tool, and PDSA cycles to test interventions in their centers to increase CGM use among all PwT2D. The coordinating center used statistical process control charts to evaluate the effectiveness of the interventions.

Results: Participating centers improved their CGM adoption, equitably, by 11% over 20 months impacting 3219 PwT2D (Figure 1). Successful strategies highlighted include redesigning of CGM prescription workflows, use of technology navigators, audio- visual educational materials in multiple languages, use of electronic health records to screen for CGM use and to track CGM use.

Conclusion: This project demonstrates that cross-learning and the use of QI and health equity principles can increase CGM use for all PwT2D.

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