2043-P: From Access to Impact: Uninsured Patients Realize Enhanced Self-Efficacy and Improved Outcomes with Interprofessional Support for Continuous Glucose Monitoring in Primary Care

Introduction and Objective: Continuous Glucose Monitors (CGMs) have revolutionized care for patients with diabetes. However, the benefits have largely evaded the uninsured, who bear elevated risk for diabetes-related complications. To date, there exist little data on CGM implementation or outcomes in this population, particularly in primary care settings where patients may most readily engage. With new funding, our interprofessional (IP) academic practice seeks to address this disparity. Methods: In our urban practice centering primary care for the underserved, diabetes prevalence approaches 60%. Uninsured patients with A1Cs 9% are provided 90-day CGM supplies via grant funding. At onboarding, patients receive equipment, training, and complete surveys. A1C is measured pre- and post-intervention, and exit interviews are performed. Results: Within our practice's intensive IP diabetes management project (n=253), 39 uninsured patients have completed the CGM program. Mean A1C upon entry is 11.14% (SD 2.09). Three months later mean A1C is 8.48% (SD 1.78), a 2.66% reduction (p.001). Ethnicity is diverse; 67% are Latino, 18% Black, 15% Asian. Most are non-English speakers (56%). Over 90% develop healthier behaviors, improving diet, hydration, engagement with glucose measurements and support team, and medication adherence. Patients rate CGM use as easy, helpful, accurate, and empowering. Conclusion: Supportively implementing CGMs with the uninsured, the IP team forges a therapeutic alliance with otherwise vulnerable patients, foregrounding individual needs and nurturing patient trust and self-efficacy. With clinicians’ ongoing engagement and nimble therapeutic adjustments, patients achieve A1C reductions outstripping those seen in studies of more advantaged populations. Complications including hospitalizations are minimized, suggesting upfront investment can substantially reduce downstream diabetes-related costs to patients and systems. Disclosure J. Ehrlich: None. D. Ezzo: None. T. Cantilli: None. N. Kaur: None. A. Jainarine: None. D.J. Coletti: None. Funding American Board of Internal Medicine Foundation, Building Trust through Diversity, Health Care Equity, & Inclusion in Internal Medicine Training Grant