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Improving Equitable Access to Continuous Glucose Monitors for Alabama's Children with Type 1 Diabetes: A Quality Improvement Project. Diabetes Technol Ther 2022 Jul;24(7):481-491



Pubmed ID




Scopus ID

2-s2.0-85133682919 (requires institutional sign-in at Scopus site)   4 Citations


Background: Continuous glucose monitors (CGMs) are a tool that can reduce the burden of self-monitoring of glucose values in children and adults with type 1 diabetes (T1D), are associated with improved glycemic control, and are associated with reduced fear of hypoglycemia. Unfortunately, disparities in access to CGM exist and rates of CGM access in Alabama in 2019 were below national averages. We aimed to increase CGM access and reduce disparities in access by race, insurance status, and high-risk diabetes status. Methods: Stakeholder input identified barriers to CGM access and defined the existing process. Process changes were implemented and studied for effect. Data were collected from the electronic health record to track rates of CGM access in patients aged 2 years and above with T1D for >3 months. Results: For the eligible population, rates of CGM access increased from a baseline of 50% to 82%. Rates for CGM access in patients with high-risk T1D increased from 34% to 85%. Disparity in CGM access for non-Hispanic Whites and non-Hispanic Blacks decreased from 18% to 6%. Disparity in CGM access for privately insured and Medicaid-insured patients decreased from 38% to 12%. Conclusions: Targeted quality improvement projects using stakeholder input can increase access to diabetes technology while reducing disparities. As technology advances, concerted efforts are needed to ensure equitable access to evolving therapies for all patients with T1D.

Author List

Schmitt J, Fogle K, Scott ML, Iyer P


Pallavi Iyer MD Chief, Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Blood Glucose
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 1
Health Services Accessibility
Hypoglycemic Agents
Quality Improvement