Background: Traditional markers of glycemic control – such as quarterly A1C measurements and patient-reported self-monitored blood glucose – offer only brief, intermittent views of glucose trends. These limited snapshots can delay necessary therapy adjustment and often contribute to inadequate glycemic control. Continuous glucose monitoring (CGM), by contrast, provides real-time, detailed glucose information that supports more timely clinical decisions and a more proactive approach to diabetes management. Current guidelines now recommend CGM not only for individuals using insulin but also for those on any form of glucose-lowering therapy. Despite the expansion, pharmacist-led remote monitoring of CGM data remains limited. At the Piedmont Columbus Family Medicine Center, patients referred for diabetes management share CGM data with clinical pharmacists for ongoing remote assessment and intervention. Pharmacists conduct weekly remote monitoring outside of standard clinic appointments, including scheduled phone visit with patients to meet study criteria. This study will assess changes in A1C,hypoglycemia events utilizing time below range (TBR) <70 mg/dL from CGM initiation through study completion, and will characterize the pharmacist-driven interventions employed to optimize glycemic control.
Methods: This single-center, retrospective, and IRB-approved study included adult patients with Type 1 or Type 2 diabetes, a baseline A1c >7%, and active use of a continuous glucose monitor capable of remote data sharing. Patients with available CGM data between July 1, 2025, and December 31, 2025, were included. Baseline demographics, A1C, and CGM summary metrics were extracted from the electronic medical record. Primary outcomes were changes in A1C and time below range (TBR) from baseline to study completion. Pharmacist interventions were recorded and categorized. Only CGM reports with adequate sensor wear time were included. Pre-post comparisons will be analyzed using paired statistical methods.
Results: A total of 19 patients were included in this study. Mean baseline A1c was 9.4%, which was decreased to 8% following pharmacy intervention, reflecting a mean reduction of 1.4% (p=0001). Nearly all participants (94.7%) experienced an A1c reduction, and 21.1% achieved glycemic control with A1c <7%. Hypoglycemia events (TBR <70 mg/dL) occurred in 42% of patients at baseline and 37% at follow-up. Pharmacists delivered a total of 473 interventions with the most being diabetes education (n=211).
Conclusions: Implementation of a pharmacist-CGM collaboration was associated with clinically meaningful improvements in glycemic control among adults with uncontrolled diabetes. These findings suggest that pharmacy-CGM collaboration can enhance diabetes management in ambulatory care settings. Future work should explore barriers to completing phone visits and evaluate scalability in larger populations.
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