Greenfield

This research aims to evaluate whether a Diabetes Care Management Program using a continuous glucose monitor (CGM) combined with remote patient monitoring (RPM) can improve blood sugar control and reduce diabetes-related distress in adults with uncontrolled type 2 diabetes. The study focuses on underserved populations receiving care at safety net clinics, where managing diabetes is challenging due to complex health and social factors. The program also seeks to assess clinician and patient satisfaction with this approach. Participants will use a CGM device to continuously monitor glucose levels, allowing them and their healthcare team to see how lifestyle factors and medications affect blood sugar. The program includes real-time remote monitoring of glucose data by the diabetes primary care team, who will contact participants to adjust treatments as needed. Initially, all participants will wear the CGM continuously, with those on insulin using it throughout the 52-week study and others wearing it continuously for 12 weeks and intermittently afterward. Educational support and endocrinology expertise will be provided remotely to healthcare providers through telemedicine and continuing medical education. Throughout the 52-week study, participants will complete assessments including the "Problem Areas in Diabetes" questionnaire to measure diabetes-related distress. Glucose control will be tracked by measuring changes in A1c and the percentage of time glucose levels remain within the target range at multiple time points. The program includes weekly review of CGM data via RPM, with outreach to participants who have low time in range or missing sensor data. The study also monitors healthcare provider satisfaction and engagement with educational sessions, aiming to improve diabetes care in underserved settings.