Greenfield

Researchers are evaluating a Diabetes Care Management Program that uses a continuous glucose monitor CGM alongside remote patient monitoring RPM to help individuals with uncontrolled type 2 diabetes seen in safety net clinics. The study aims to improve glucose levels, measured by A1c and time spent within target glucose range, as well as reduce diabetes-related distress. The program also seeks to assess satisfaction among patients and primary care providers. The study is prospective and involves underserved populations facing social, racial, and economic inequities in healthcare. Participants will wear a CGM device to continuously monitor glucose levels, allowing them to see how food, physical activity, and medications affect their glucose in real time. The diabetes care team will remotely monitor these glucose readings via RPM and contact participants to adjust treatment as needed. The study includes a 24-week intervention period with an optional 28-week extension. Insulin users will wear CGM continuously for 52 weeks, while non-insulin users will wear it continuously for 12 weeks and intermittently afterward. Educational support for providers and staff will be provided through telemedicine and e-consults with endocrinologists. During the study, participants will complete questionnaires about diabetes-related distress and satisfaction with care. Researchers will measure changes in A1c, time in glucose target range, and problem areas in diabetes at multiple time points up to 52 weeks. Patient and provider satisfaction will also be assessed. Weekly reviews of CGM data will guide treatment adjustments, and participants will have follow-up visits to discuss glucose data. The total participation may last up to 52 weeks, including the optional extension.