IMPLEMENTATION OF CONTINUOUS GLUCOSE MONITORING PROTOCOL IN PRIMARY CARE

Diabetes Mellitus (DM) is a global public health problem, with 537 million adults aged20-79 worldwide diagnosed with DM in 2021 (International Diabetes Federation [IDF], 2021). InNorth Carolina (NC), 12.4% of adults have DM, and 34.6% have pre-diabetes (ADA, 2021).According to the 2019 report from Duplin County Healthy Communities, the rate of DM washigher than the state average at 16.5% (Healthy Communities, 2019). Healthy People's 2030goal is to increase the proportion of adults with DM who use insulin to monitor their blood sugardaily from 86.5% in 2019 in the US to a target of 94.4% by 2030 (Healthy People, 2022). NorthCarolina is below the US average, with only 63.6% of people with DM on insulin checking theirglucose one or more times a day (North Carolina Department of Health and Human Services [NCDHHS], 2022).Continuous glucose monitoring (CGM) provides people with diabetes with a less painful,more frequent glucose reading and improves compliance with monitoring frequent blood sugarlevels (Kieu et al., 2023). The ADA standards of care guidelines for 2025 have recommendedCGM for all patients with type 2 DM (T2DM) who currently use multiple daily injections(MDI), mixed insulin therapies, basal insulin, or documented hypoglycemic events (El Sayed etal., 2023). Primary care providers (PCPs) with specialized training in diabetes technology,coding, billing, and CGM implementation and interpretation are more likely to prescribe CGMs and provide individualized diabetes care to their patients with insulin-dependent DM (Ajjan etal., 2019; Diamond, 2023; Filippi et al., 2023; Martens et al., 2021).The intervention for this quality improvement project was to provide specialized CGMtraining to eight PCPs in eastern NC and monitor the number of CGM prescriptions and thenumber of CGM CPT billing codes over 13 weeks of project implementation. The results showedan increase in CGM prescriptions by 7.29%, with 17 prescriptions from July 1, 2024, toNovember 1, 2024, and an increase of CPT CGM billing codes from zero to 31 from the same time.