CGM Access: Language & Health Disparities

Language Barriers Impact Diabetes care: CGM Prescriptions Lag for Non-English Speakers

Boston, MA – June 27, 2025 – A new study reveals a significant disparity in access to continuous glucose monitors (CGM) for patients with type 2 diabetes (T2D) based on language preference. The research, published in JAMA Network Open, indicates that adult patients with a non-English language preference (NELP) are less likely to receive CGM prescriptions compared to their English-speaking counterparts.

The study, led by Dr. Jorge A. Rodriguez from Brigham and Women’s Hospital, analyzed data from over 69,000 patients with T2D receiving primary or endocrinology care between January 2022 and December 2023. The findings underscore the critical role language plays in healthcare access and outcomes for diabetes management.

Key Findings: Disparities in diabetes Management

Researchers found that only 7.4% of patients with NELP had a CGM prescription, compared to 12.7% of patients with English language preference (ELP). After adjusting for other factors, patients with NELP were still substantially less likely to receive a CGM prescription (adjusted odds ratio 0.58).

This disparity persisted even among patients with uncontrolled diabetes (hemoglobin A1c >9%) and those using insulin, highlighting a systemic issue in healthcare delivery.

The Impact of Language on Healthcare Access

“Our study highlights the specific role of language preference in CGM prescribing patterns,”

The authors emphasize the need to address language barriers to ensure equitable access to diabetes management technology. This is especially crucial given that effective diabetes management relies on continuous monitoring and timely intervention.

Understanding the Role of Continuous Glucose Monitors

Continuous glucose monitors (CGMs) have revolutionized diabetes care by providing real-time glucose readings, trends, and alerts. This allows patients to make informed decisions about their diet, exercise, and medication, leading to better blood sugar control and reduced risk of complications. Such as, CGMs can also help patients prevent hypoglycemic events.

Did You Know? Studies have shown that CGM use is associated with improved A1c levels, reduced time spent in hypoglycemia, and increased quality of life for people with diabetes.

CGM Prescription Rates: A Comparison

Language Preference	CGM Prescription Rate
English Language Preference (ELP)	12.7%
Non-English Language Preference (NELP)	7.4%

Addressing the Disparities: A Path Forward

Closing the gap in CGM access requires a multi-faceted approach. Healthcare providers need to be more aware of language barriers and implement strategies to overcome them.These strategies may include:

• Providing translated educational materials
• Utilizing interpreter services
• Offering culturally tailored diabetes education programs
• Increasing diversity within the healthcare workforce

Pro Tip: Healthcare systems can leverage technology, such as telehealth platforms with integrated translation services, to improve communication and access for patients with NELP.

Why does this disparity exist, and what steps can patients take to advocate for their healthcare needs?

How can healthcare systems ensure equitable access to diabetes technology for all patients, regardless of language preference?

The Broader Context: Diabetes and Health equity

Diabetes is a significant public health concern, affecting millions worldwide. According to the CDC, over 37 million Americans have diabetes, and the prevalence is increasing. Moreover, certain racial and ethnic groups are disproportionately affected by diabetes, highlighting the need for targeted interventions to address health inequities.

The German federal Ministry of Health defines diabetes mellitus as a metabolic disorder characterized by elevated blood sugar levels due to insulin deficiency or resistance. understanding the different types of diabetes (Type 1 and Type 2) is crucial for effective management and prevention.

Looking Ahead: The Future of Diabetes Care

The future of diabetes care will likely involve increased use of technology,personalized medicine,and a greater emphasis on prevention. Continuous glucose monitors, insulin pumps, and artificial pancreas systems are already transforming the lives of many people with diabetes. As technology advances, these tools will become more accessible and user-pleasant.

In addition, researchers are exploring new approaches to prevent and cure diabetes, including immunotherapies, stem cell therapies, and gene editing. By investing in research and innovation,we can create a future where diabetes is no longer a major public health threat.

Frequently Asked Questions About Diabetes and CGM Access

• Why is there a disparity in CGM prescriptions for non-English speakers with type 2 diabetes?

  Several factors may contribute, including communication barriers, lack of culturally tailored education, and potential biases in healthcare provider recommendations.

• What is a continuous glucose monitor (CGM) and how does it help people with diabetes?

  A CGM is a device that tracks glucose levels in real-time, providing valuable data to help manage blood sugar and prevent complications from diabetes.

• How can healthcare providers improve access to CGMs for non-English speaking patients?

  Offering translated materials, using interpreter services, and providing culturally sensitive diabetes education can help bridge the gap.

• What is hemoglobin A1c and why is it important for diabetes management?

  hemoglobin A1c is a blood test that reflects average blood sugar levels over the past 2-3 months. Keeping A1c levels in the target range is crucial for preventing long-term complications of diabetes.

• what are the potential consequences of uncontrolled diabetes?

  Uncontrolled diabetes can lead to serious health problems, including heart disease, kidney disease, nerve damage, and vision loss.

What are the potential economic implications of implementing multilingual CGM resources for diverse patient populations?

CGM Access: Tackling Language Barriers and Reducing Health Disparities

Continuous Glucose Monitoring (CGM) is a transformative technology for diabetes management. However, equitable access to CGM systems is often hindered by language barriers and other factors that contribute to health disparities. this article explores these challenges,highlighting the impact on patient outcomes and potential solutions for improved access and understanding.

The Impact of Language on CGM Usage and Outcomes

Language plays a crucial role in healthcare, particularly for complex technologies like CGM. When patients don’t fully understand device instructions, training materials, or data interpretations, they face significant challenges.

Challenges Faced by Non-English Speakers Using CGM

• Difficulty Understanding Instructions: Instructions and manuals are frequently enough exclusively in English, creating a steep learning curve.
• Misinterpretation of Data: Misunderstanding glucose trends and alerts can lead to inappropriate insulin dosing and poor glycemic control.
• Reduced Engagement: Communication difficulties with healthcare providers limit the patient’s ability to ask questions and actively participate in their care.
• Increased Risk of Complications: Suboptimal diabetes management due to language barriers leads to a higher risk of both acute and long-term diabetes complications.

Health Disparities Related to CGM access

Language is a significant contributor to health disparities, affecting various demographic groups. These disparities can result in unequal access to care and poorer health outcomes.

The availability of translated materials and culturally sensitive training affects patient outcomes significantly.Consider the following case study:

Case Study: Maria’s Story

Maria, a Spanish-speaking woman with type 1 diabetes, was prescribed a CGM. However, all the educational materials were in English. This resulted in numerous misunderstandings and her blood sugar levels were poorly controlled. After receiving bilingual support and translated documents, her understanding improved, as did her HbA1c.

Key populations facing challenges include:

Population Group	common Language Barriers	Impact on CGM Use
Hispanic/Latino	Spanish	Reduced data interpretation, poor adherence
Asian Communities	Mandarin, Cantonese, Vietnamese, Korean	Difficulty understanding alarms, low utilization
Refugee Populations	Various languages	Lack of access to training, fear of new technology

Strategies for Improving CGM Access and Addressing Language Barriers

Several strategies can definitely help to bridge the language gap and improve access to CGM and improve diabetes management for all patients.

Best Practices for Healthcare Providers

• Offer Bilingual Staff and Interpreters: Ensure access to trained medical interpreters during consultations and training sessions.
• provide culturally Tailored Education: Create educational materials that are culturally sensitive and respect patients’ backgrounds.
• Use Visual Aids and Simplified Language: Simplify instructions and utilize visuals to communicate complex facts.
• Promote Patient Empowerment: Encourage family members and community leaders to take part in support and patient education.

Technology & Resources

Leveraging technology can support patients and clinicians alike.

• Translated Resources: Develop and utilize translated CGM user manuals, training videos, and mobile device applications.
• Multilingual Applications: Ensure CGM apps and related software are available in multiple languages.
• Telemedicine and Remote Monitoring Implement remote blood glucose monitoring platforms that can integrate with existing support systems .

The Benefits of Addressing Language Barriers in CGM Access

Addressing language barriers and improving access to CGM has far-reaching positive effects.

Improved Clinical Outcomes

• Better Glycemic Control: Improved understanding of glucose trends leads to better control of diabetes.
• Reduced Complications: Decreased risk of hypoglycemia, hyperglycemia, and long-term complications, such as diabetic retinopathy and kidney disease.
• Increased Patient Satisfaction: Patients participating in their care and able to receive tailored language support tend to have a far higher degree of satisfaction with their diabetes management.

Enhanced Health Equity

• Reduced Disparities:** this ensures that underserved populations receive equal access and is essential to improve equity.
• Improved Population Health: Addressing linguistic challenges leads to improved health outcomes for greater communities.

By addressing language barriers and health disparities, healthcare providers, policymakers, and technology developers can make CGM accessible to all.This is an essential step to improving diabetes management and health outcomes for diverse populations.