Navigating Continuous Glucose Monitoring Adoption: Insights From Hispanic Adults With Insulin-Treated Type 2 Diabetes

Hispanic individuals are disproportionately affected by type 2 diabetes (T2D) and face access limitations in diabetes technology utilization. Despite proven benefits, continuous glucose monitoring (CGM) use remains low among Hispanic adults with insulin-treated T2D. This study used a social-ecological model (SEM) framework to identify societal/policy, interpersonal/community, and individual level barriers to CGM access and adoption within this population.

Two focus groups were conducted in Spanish at the University of Miami (UM) with Hispanic adults (n = 16) with T2D. Inclusion criteria were age ≥18 years, HbA1c ≥8%, ≥1 daily insulin injection, and no CGM use in the past 2 years. The initial focus group was conducted to identify barriers to CGM initiation. At the end of the focus group, participants were provided with real-time CGMs for 30 days of use. After completing the wear period, the same participants returned for a follow-up focus group to explore factors related to CGM adoption and acceptance. Focus groups were analyzed using a thematic analysis, systematically coding and categorizing key concepts and ideas expressed by participants.

The mean age was 59.68 ± 13.37 years, and baseline HbA1c was 9.78 ± 1.14. Key barriers included high device costs, limited insurance coverage, alarm fatigue, and lack of culturally concordant provider guidance. Facilitators for CGM use included manufacturer discounts, peer modeling, and the desire to avoid fingersticks. After a 30-day CGM trial, most participants reported improved dietary awareness, glycemic control, and a strong desire for continued use.

This pilot study provides novel insights into the experiences of the Hispanic population and highlights the complex interplay of societal, interpersonal, and individual-level factors influencing CGM use. Tailored interventions addressing these barriers are crucial for improving CGM utilization in this population.