Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project
Federally Qualified Health Centers (FQHCs) provide service to medically underserved areas and communities, providing care to over 32 million patients annually. The burden of diabetes is increasing, but often, the vulnerable communities served by FQHCs lag in the management of the disease...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2025-02-01
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| Series: | JMIR Diabetes |
| Online Access: | https://diabetes.jmir.org/2025/1/e68324 |
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| _version_ | 1832096584001650688 |
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| author | Madhur Thakur Eric W Maurer Kim Ngan Tran Anthony Tholkes Sripriya Rajamani Roli Dwivedi |
| author_facet | Madhur Thakur Eric W Maurer Kim Ngan Tran Anthony Tholkes Sripriya Rajamani Roli Dwivedi |
| author_sort | Madhur Thakur |
| collection | DOAJ |
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Federally Qualified Health Centers (FQHCs) provide service to medically underserved areas and communities, providing care to over 32 million patients annually. The burden of diabetes is increasing, but often, the vulnerable communities served by FQHCs lag in the management of the disease due to limited resources and related social determinants of health. With the increasing adoption of technologies in health care delivery, digital tools for continuous glucose monitoring (CGM) are being used to improve disease management and increase patient engagement. In this viewpoint, we share insights on the implementation of a CGM program at an FQHC, the Community-University Health Care Center (CUHCC) in Minneapolis, Minnesota. Our intent is to improve diabetes management through better monitoring of glucose and to ensure that the CGM program enables our organization’s overarching digital strategy. Given the resource limitations of our population, we provided Libre Pro devices to uninsured patients through grants to improve health care equity. We used an interdisciplinary approach involving pharmacists, nurses, and clinicians and used hemoglobin A1c (HbA1c) levels as a measure of diabetes management. We assessed the CGM program and noted key aspects to guide future implementation and scalability. We recruited 148 participants with a mean age of 54 years; 39.8% (59/148) self-identified their race as non-White, 9.5% (14/148) self-identified their ethnicity as Hispanic or Latino, and one-third (53/148, 35.8%) were uninsured. Participants had diverse language preferences, with Spanish (54/148, 36.5%), English (52/148, 35.1%), Somali (21/148, 14.2%), and other languages (21/148, 14.2%). Their clinical characteristics included an average BMI of 29.91 kg/m2 and a mean baseline HbA1c level of 9.73%. Results indicate that the CGM program reduced HbA1c levels significantly from baseline to first follow-up (P<.001) and second follow-up (P<.001), but no significant difference between the first and second follow-up (P=.94). We share key lessons learned on cultural and language barriers, the digital divide, technical issues, and interoperability needs. These key lessons are generalizable for improving implementation at FQHCs and refining digital strategies for future scalability. |
| format | Article |
| id | doaj-art-550eeba65251489f8efbbda232d0ae4d |
| institution | Kabale University |
| issn | 2371-4379 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Diabetes |
| spelling | doaj-art-550eeba65251489f8efbbda232d0ae4d2025-02-05T13:32:47ZengJMIR PublicationsJMIR Diabetes2371-43792025-02-0110e6832410.2196/68324Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation ProjectMadhur Thakurhttps://orcid.org/0009-0005-8130-6945Eric W Maurerhttps://orcid.org/0000-0002-5337-1433Kim Ngan Tranhttps://orcid.org/0009-0002-8792-7855Anthony Tholkeshttps://orcid.org/0000-0002-8854-5544Sripriya Rajamanihttps://orcid.org/0000-0002-5941-7500Roli Dwivedihttps://orcid.org/0000-0002-1094-0472 Federally Qualified Health Centers (FQHCs) provide service to medically underserved areas and communities, providing care to over 32 million patients annually. The burden of diabetes is increasing, but often, the vulnerable communities served by FQHCs lag in the management of the disease due to limited resources and related social determinants of health. With the increasing adoption of technologies in health care delivery, digital tools for continuous glucose monitoring (CGM) are being used to improve disease management and increase patient engagement. In this viewpoint, we share insights on the implementation of a CGM program at an FQHC, the Community-University Health Care Center (CUHCC) in Minneapolis, Minnesota. Our intent is to improve diabetes management through better monitoring of glucose and to ensure that the CGM program enables our organization’s overarching digital strategy. Given the resource limitations of our population, we provided Libre Pro devices to uninsured patients through grants to improve health care equity. We used an interdisciplinary approach involving pharmacists, nurses, and clinicians and used hemoglobin A1c (HbA1c) levels as a measure of diabetes management. We assessed the CGM program and noted key aspects to guide future implementation and scalability. We recruited 148 participants with a mean age of 54 years; 39.8% (59/148) self-identified their race as non-White, 9.5% (14/148) self-identified their ethnicity as Hispanic or Latino, and one-third (53/148, 35.8%) were uninsured. Participants had diverse language preferences, with Spanish (54/148, 36.5%), English (52/148, 35.1%), Somali (21/148, 14.2%), and other languages (21/148, 14.2%). Their clinical characteristics included an average BMI of 29.91 kg/m2 and a mean baseline HbA1c level of 9.73%. Results indicate that the CGM program reduced HbA1c levels significantly from baseline to first follow-up (P<.001) and second follow-up (P<.001), but no significant difference between the first and second follow-up (P=.94). We share key lessons learned on cultural and language barriers, the digital divide, technical issues, and interoperability needs. These key lessons are generalizable for improving implementation at FQHCs and refining digital strategies for future scalability.https://diabetes.jmir.org/2025/1/e68324 |
| spellingShingle | Madhur Thakur Eric W Maurer Kim Ngan Tran Anthony Tholkes Sripriya Rajamani Roli Dwivedi Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project JMIR Diabetes |
| title | Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project |
| title_full | Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project |
| title_fullStr | Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project |
| title_full_unstemmed | Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project |
| title_short | Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project |
| title_sort | enhancing health equity and patient engagement in diabetes care technology aided continuous glucose monitoring pilot implementation project |
| url | https://diabetes.jmir.org/2025/1/e68324 |
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