Improving Continuous Glucose Monitoring Access Among Adults With Type 1 Diabetes in an Urban Safety-Net Hospital

OBJECTIVE To increase continuous glucose monitoring (CGM) access among adults with type 1 diabetes at the Grady Diabetes Center and identify barriers to technology adoption. RESEARCH DESIGN AND METHODS We conducted an 11-month quality improvement initiative using sequential plan-do-study-act cycles led by a multidisciplinary team. Interventions included standardizing CGM workflows, training staff to document active device use, implementing a structured CGM education program, and using a pilot survey to facilitate discussion of CGM during clinical encounters. RESULTS CGM access increased from 46% to 65% over the intervention period. While the proportion of patients achieving HbA1c 8% remained stable (22% vs. 24%), the first cohort completing CGM classes demonstrated a 10.7% mean increase in time in range without increased hypoglycemia. Notably, early survey data revealed that CGM prescriptions did not consistently translate into device initiation, underscoring persistent downstream barriers to actual use. CONCLUSIONS Targeted CGM workflow redesign, combined with structured CGM education, improved CGM uptake and glycemic outcomes. Sustained improvement will depend on continued integration of CGM data into clinical workflows, streamlining prescription processes and building educational infrastructure.