Increased CGM Utilization, Education Needed for Low-Income Communities

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In an abstract presented at ENDO 2024, researchers addressed practitioners’ current knowledge of CGM and their experience prescribing in low-income communities.

As continuous glucose monitoring (CGM) technology advances and becomes more available, it’s important that low-income communities attain better access and education regarding its benefits.

Increased CGM Utilization, Education Needed for Low-Income Communities / stivog - stock.adobe.com

Increased CGM Utilization, Education Needed for Low-Income Communities / stivog - stock.adobe.com

“More than 100 million Americans have prediabetes or diabetes, with more than 10 million using insulin. Hence, access to CGM is crucial for patients for better management. Despite the benefits, many factors play a role in limiting their use, including prescription, cost, insurance coverage, social factors, willingness of the patients, discomfort, and decreased knowledge,” wrote authors of the abstract presented at ENDO 2024.1

CGM is becoming the standard of care for patients with diabetes to measure and control blood glucose levels. To address the current lack of CGM in low-income communities, researchers aimed to assess the current knowledge of the technology in a community hospital outpatient clinic that serves a low-economic population.1

Researchers sent internal medicine (IM) residents a survey asking them various questions on their knowledge of CGM and if more training is necessary to gain a further understanding of the technology.

The study included responses from 50 IM residents, 78% of which answered that they knew what CGM was and were able to correctly identify the technology. Further assessing the residents’ current knowledge of CGM, 70% of respondents had prescribed it in the past.

However, aside from surface-level identification of the technology, respondents reported a lack in current understanding of CGM and how to administer it to patients.

Just 14% of the residents had formal CGM training, 34% knew how to apply the device to patients, and only 42% knew how to interpret blood glucose levels. Furthermore, over 95% reported poor/beginner or fair knowledge about the usage, application, and interpretation of CGM.1

Finally, 80% of the IM residents admitted that more training of CGM technology was necessary to gain more confidence in prescribing and administering it to patients.

READ MORE: Addressing The Need for Better Access to CGM in Low-Income Areas

The researchers’ findings present a 2-fold dilemma for diabetes patients in low-income communities.

First, indigent communities already experience higher rates of diabetes and a need for better technology to control and monitor blood glucose levels. “Children and adolescents from very-low-income to middle-income families had a higher hazard of youth-onset type 2 diabetes and mortality than those from high-income families,” according to a study published in JAMA Network Open.2 While this study only focuses on early-onset diabetes in low-income communities, a higher number of diabetes cases has been well-documented in similar populations.

Secondly, despite the technology advancing and becoming more available, without clinicians who understand the capabilities and application of CGM, these communities will not be able to benefit from this standard of care.

To combat these issues, authors of the ENDO abstract suggest that pharmacists must play a role in continuing education and administration of CGM in these communities.

“After the survey, our PharmD conducted [a] session demonstrating the indications, types, usage, application, and interpretation of CGM. Following this, an impactful increase in patients who were appropriately prescribed and received CGM was observed,” they wrote.1

Furthermore, the authors identified another previous study that examined the change in CGM use from 2014 to 2020. During that time span, CGM use increased by almost 10 times. However, most patients included in the study were younger, employed, and had better insurance coverage.1

Further solidifying the lack of access for CGM, low-income communities deserve greater attention for establishing the technology as the standard of care in an affordable capacity.

“Continued efforts to increase awareness is required to ensure that latest advances are adequately incorporated into graduate medical education,” concluded the authors.1

Click here for more of our coverage from ENDO 2024.

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References
1. Mehta V, Deshpande S, Nieman M, et al. Enhancing CGM use in lower economic community hospitals. Presented at: ENDO 2024; June 1-4; Boston, MA.
2. Yen F, Wei JCC, Liu J, et al. Parental income level and risk of developing type 2 diabetes in youth. JAMA Netw Open. 2023;6(11):e2345812. doi:10.1001/jamanetworkopen.2023.45812
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