Proactive Diabetes Specialist Care to Optimize Continuous Glucose Monitoring in Adults with Diabetes Using Insulin Therapy

This project will pilot a proactive approach for optimizing continuous glucose monitoring (CGM) for people with insulin-dependent diabetes. Our intervention will rapidly connect Certified Diabetes Care and Education Specialists (CDCES) to patients currently using CGM who are not at glycemic goals.

Funder(s):

Helmsley Charitable Trust

Funding Amount:

$466,093

Project Duration:

September 1, 2025 – October 31, 2028

Project Collaborators at UPMC:

UPMC Division of Endocrinology and Metabolism; UPMC Health Plan; UPMC Center for High-Value Health Care

Project Location:

Western Pennsylvania

Background: CGM provides real-time glucose data that can be used by people with diabetes and their health care team to make treatment and lifestyle adjustments that can help lead to better blood glucose control. People with diabetes sometimes encounter challenges using CGM devices, such as cost, discomfort, and interpreting CGM data. Providers may also experience challenges supporting their patients who use CGM because of a lack of time and training. These barriers can reduce the effectiveness of CGM and lead to treatment delays.

Healthcare challenge: CDCES play an important role in helping patients and providers use CGM effectively, yet they are often underutilized in primary care. UPMC has demonstrated that proactive, technology-enabled support can connect diabetes specialists with primary care teams and help reduce common barriers to diabetes care. Applying this model to CDCES may improve CGM use and help patients achieve better outcomes.

Goals:

Adapt a proactive eConsult intervention (called TACos+) to address barriers to CGM use for people with insulin-dependent diabetes
Evaluate the impact of TACos+ on glycemic control
Work with a multi-stakeholder group of patients, payers, and providers to inform long-term sustainability of the pilot intervention

Implementation Approach:

Targeted automatic eConsults (TACos) are a proactive healthcare intervention designed to efficiently deliver treatment to patients and provide decision-support to primary care providers. The goal of this project is to pilot an adapted version of TACos, TACos+, which will make available Certified Diabetes Care and Education Specialist (CDCES) support to patients with insulin-dependent diabetes who have been prescribed continuous glucose monitoring (CGM) but are not meeting recommended glycemic goals. Our TACos+ intervention will incorporate a feedback loop for primary care providers, alerting them to patient needs and challenges while supporting interpretation of data from CGM devices and helping to inform treatment planning. This project will also evaluate TACos+ using quantitative and qualitative methods to assess its impact on key outcomes and collect implementation data to inform refinement and scalability.