How One Hospital Helped More People With Type 1 Diabetes Access CGM Technology

Continuous glucose monitoring can help people with Type 1 diabetes see real-time blood sugar patterns and reduce both highs and lows. Yet access to CGM remains uneven, especially in safety-net hospitals that serve uninsured and underinsured patients. At Grady Diabetes Center in Atlanta, less than half of adults with Type 1 diabetes were using CGM at the start of 2024.

A team of doctors, diabetes educators, nurses, and administrators decided to investigate why—and what they could do about it. Over 11 months, they implemented a series of changes designed to make CGM use easier to prescribe, easier to understand, and easier to sustain.

The interventions were practical and systematic. Staff standardized how CGM workflows worked across the clinic—eliminating confusion about who orders devices, when, and how. They trained team members to accurately track which patients actually had active devices in use, not just prescriptions on paper.

Education became more structured. Instead of brief mentions of CGM during routine visits, the program added dedicated CGM classes where patients could learn how the technology works, how to wear and manage it, and how to use the data to improve their health. The team also created a simple survey tool to help clinicians talk about CGM during appointments and understand what concerns or questions patients had.

By the end of the intervention period, CGM access jumped to 65%—a 19-percentage-point gain. That change alone matters: more people had tools to manage their diabetes more precisely.

Among patients who completed the structured CGM education classes, average time in range (the percentage of time blood sugar stayed in a healthy target zone) increased by 10.7%. This improvement occurred without a rise in hypoglycemic episodes—meaning better control without more lows.

Overall HbA1c rates (a three-month average of blood sugar) showed little change at the population level (22% achieved target at baseline, 24% at the end), suggesting that workflow and education improvements helped people use CGM more effectively, but that durability and adherence remain challenges.

One important finding emerged: not everyone who received a CGM prescription actually started the device. This gap—between access and actual use—hints at barriers that go beyond simply getting a device approved or dispensed. Insurance complications, confusion about setup, worry about wearing a sensor, or lack of follow-up support can all prevent prescriptions from becoming real outcomes.

This discovery is why the team emphasized that sustainable improvement requires more than one-time fixes. Clinicians need to actively incorporate CGM data into their routine care conversations. The prescription process itself must be streamlined. And educational infrastructure—both initial training and ongoing support—must be built into clinic operations, not added as an afterthought.

The Grady initiative shows that deliberate, multi-level redesign can move the needle on CGM access in settings that serve vulnerable populations. Standardizing workflows removes friction. Training staff ensures consistency. Dedicated education gives patients the knowledge and confidence they need. And simple feedback tools help clinicians make CGM a regular part of the conversation.

The work also underscores that access and use are not the same. The next frontier is supporting patients after they receive a prescription—ensuring they actually initiate the device, troubleshoot problems, and integrate it into their daily routine. For centers aiming to close the diabetes technology gap, that sustained follow-up may be just as important as the initial breakthrough in access.

Source: Diabetes, obesity, and cardiometabolic CARE. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.