Impact of continuous glucose monitoring in underserved adults with type 2 diabetes within the United States: A scoping review

BackgroundContinuous glucose monitoring (CGM) has improved diabetes management but remains underused among low-income populations who have a higher diabetes prevalence. With the additional consideration of socioeconomic factors limiting resources to maintain health, further understanding of the effectiveness of CGM in marginalized patients is needed. This scoping review synthesizes evidence on health outcomes impacted by CGM use in adults with type 2 diabetes mellitus (T2DM) receiving care in low-income settings.MethodsPRISMA-ScR guidelines were used to identify studies through PubMed, Embase, and CINAHL. A search strategy combined MeSH terms and keywords reviewing titles and abstracts. The review included English-language studies using CGM from inception to May 2024; participants 18 years or older with T2DM, and with the majority of patients meeting the pre-defined low-income status or the study being conducted in a pre-defined low-income setting. Studies in pregnant patients, meta-analyses, and systematic reviews were excluded. Two reviewers independently performed study selection, data extraction, and quality assessment. The authors received no financial support for this research.ResultsThe review identified 1176 studies, with 198 duplicates, resulting in 978 screened titles and abstracts. Forty-six studies underwent full text review, and 31 were excluded. Ultimately, 15 studies (5 abstracts, 9 manuscripts, and 1 case report) met the review criteria. CGM use led to reductions in hemoglobin A1C levels across settings such as Federally Qualified Health Centers, clinics serving the underinsured, county health departments, and rural clinics. Other benefits included reduced hypoglycemia, improved glucose levels, and increased time in range.DiscussionStudies described showed an improvement in diabetes-related clinical outcomes with CGM use in low-income patients. Limited amount of data in the studies was the main limitation of this review. Insights highlight the need for research on interventions to enhance CGM access and address barriers to promote health equity in underserved populations, especially as CGM becomes available over the counter.