JMIR Publications

ABSTRACT

Background:

Prediabetes represents a critical intervention window to reduce progression to type 2 diabetes. The current standard of care for treatment of prediabetes is weight loss and lifestyle modification, which are both highly effective, though limited by real-world adherence. It is well recognized that continuous glucose monitoring (CGM) improves glycemic and behavioral outcomes in people with diabetes, though outcomes among people with prediabetes are not well described.

Objective:

The aim of this study is to evaluate the impact of pharmacist-led CGM on glycemic control and health-related behaviors in adults with prediabetes.

Methods:

This study includes a prospective pharmacist-led CGM cohort and a matched retrospective usual-care cohort. Adults aged 18-70 years with prediabetes (HbA1c 5.7%-6.4%) will be eligible for the prospective cohort if they have a compatible smartphone and no CGM use in the prior 6 months. Participants will receive CGM (Dexcom Stelo) and diabetes self-management education and support over 12 weeks. The primary outcome is change in HbA1c versus matched historical controls. Secondary outcomes include CGM-derived metrics, change in Summary of Diabetes Self-Care Activities scores and 36-Item Short Form Health Survey scores, and CGM-related adverse effects.

Results:

This study was funded in 2026. Recruitment is ongoing, though no subjects have been enrolled at the time of writing. The planned sample size is 40 participants: 20 prospective CGM participants and 20 retrospective controls. Outcome results are not yet available. It is anticipated that we will conclude this study in July 2027 and expect to disseminate results in December 2027.

Conclusions:

This study seeks to evaluate glycemic impact, behavior change, and safety of pharmacist-led CGM for prediabetes in primary care. Clinical Trial: ClinicalTrials.gov [NCT07529366]