Continuous glucose monitoring-based care for adults with type 2 diabetes in community and ambulatory settings: a scoping review and evidence map of implementation pathways

Background The glycemic effects of continuous glucose monitoring (CGM) in adults with type 2 diabetes mellitus (T2DM) have been studied extensively, but how CGM information is translated into clinical or self-management action remains less understood. We mapped these processes and implementation conditions across ambulatory care. Methods Following Joanna Briggs Institute methodology and PRISMA-ScR guidance, we searched five bibliographic databases and ClinicalTrials.gov from January 1, 2006 to March 10, 2026, including a sensitivity search without the care-setting block. Eligible studies examined CGM-based care for adults with T2DM in community and ambulatory settings. We mapped six data-to-action components: viewer, review timing, transmission, feedback, interpretation, and action formulation. Implementation determinants and outcomes were summarized using the Consolidated Framework for Implementation Research and Proctor’s framework, respectively. Clinical, patient-experience, safety, equity, and economic findings were summarized as contextual evidence. Results 179 reports represented 132 primary clinical or implementation studies and 27 independent economic studies. All six data-to-action components were reported in 67/132 studies (50.8%). Patients were the most frequent viewers (100/132, 75.8%), and individualized clinical judgment was the most frequent action-formulation approach (45/132, 34.1%). Implementation determinants were reported in 75/132 studies (56.8%), and 80/132 (60.6%) explicitly assessed an implementation outcome. Penetration (six studies) and sustainability (five) were rarely assessed, and none explicitly assessed implementation cost. Patient-experience, equity-relevant, and safety reporting was incomplete. Most cost-effectiveness evaluations reported favorable base cases, whereas budget-impact findings varied. Conclusions CGM was delivered through heterogeneous and incompletely reported data-to-action processes. Evaluation of penetration, sustainability, and implementation cost was scarce. Future studies should evaluate clearly specified pathways and assess action follow-through, sustainability, equitable access, patient burden, safety, and service resources.