Closing the Gap: Strategies for Broader Adoption and Use of Continuous Glucose Monitors Among Children and Adolescents With Type 1 Diabetes

OBJECTIVE This project aimed to increase continuous glucose monitor (CGM) adoption and use among pediatric and adolescent patients with type 1 diabetes at the University of Michigan while reducing racial and ethnic disparities. RESEARCH DESIGN AND METHODS We conducted a quality improvement (QI) project from February 2022 through December 2023. Over the project period, several interventions were tested through plan-do-study-act cycles, including patient-facing CGM education, implementation of revised electronic health record (EHR) flowsheets to track CGM adoption and use, as well as address barriers, prescribing-related workflow changes, and provision of technical support to newly diagnosed patients starting a CGM. CGM adoption and use rates were measured and stratified by race and ethnicity. RESULTS At baseline, 87% of non-Hispanic White (NHW) patients and 75% of non-White patients had a CGM. By June 2024, adoption rates increased to 98% for NHW patients and 97% for non-White patients. CGM use (>70% of the time) also improved, reaching 89% among NHW and 88% among non-White patients. CONCLUSIONS This initiative demonstrates that QI interventions, including efforts to address individual-level barriers, can substantially increase CGM adoption and use while improving equity. The findings highlight the importance of standardizing clinic workflows and patient engagement in advancing diabetes technology adoption.