981-P: Development of a Diabetes Navigator Toolkit to Support Diabetes Technology Uptake and Sustained Use—IMPACT Toolkit

Advanced diabetes technologies (ADT), including continuous glucose monitors (CGMs), insulin pumps, and automated insulin delivery systems, improve glycemic control in Type 1 diabetes. However, these technologies are underutilized, particularly in minority and underserved populations. Barriers to ADT use are well described, yet there are limited reports of solutions to improve ADT uptake. This qualitative interview study of diabetes stakeholders aimed to develop a diabetes toolkit to help improve the uptake and sustained use of ADT.

Semi-structured interviews were conducted, specifically focusing on CGM prescription, CGM education and use, pump prescription, and pump education and use. Rapid qualitative method was employed for efficient data collection and analysis. Key themes were identified and iteratively applied to refine the toolkit.

The participants included 18 providers, 10 community/commercial partners and vendors, and 23 patients/caregivers, among whom 9 used both CGM and pump, 10 used only CGM, and 4 did not use either device. Key barriers included communication lapses, insurance/cost challenges, inadequate education, technological issues, complex processes, and limited resource accessibility. For communication gaps and clinic portal connections, appointing a central liaison such as a diabetes navigator was proposed. Solutions for insurance/cost challenges involved providing transparent cost information. Education enhancements emphasized hands-on training, and providing clear device instructions. In general stakeholders supported adopting the diabetes toolkit for improved technology uptake and use.

A diabetes toolkit could be utilized by a diabetes navigator or another diabetes care team member to help improve the uptake and sustained use of diabetes technologies despite the complex processes involved.