Currently submitted to: JMIR Research Protocols
Date Submitted: Sep 25, 2026
Open Peer Review Period: Sep 28, 2026 - Nov 23, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementation Strategies for Remote Glucose Monitoring in Safety-Net Settings: Protocol for a Scoping Review
ABSTRACT
Background:
Monitoring of blood glucose is an essential element of diabetes management and prevention of complications associated with Type 1 and Type 2 diabetes. Remote glucose monitoring (RGM) is one solution that may improve diabetes care. RGM involves collecting blood glucose measurements and transmitting them electronically to an electronic health record for clinician review. However, documentation of RGM implementation in real-world settings is limited, particularly in U.S. safety-net settings, where systems may have fewer resources and patients face structural barriers such as poor internet connectivity, low digital literacy, and social determinants of health needs. Prior studies have documented barriers and facilitators to RGM, but no comprehensive review has been done to map these factors and identify opportunities for improved implementation in safety-net settings.
Objective:
This scoping review seeks to systematically map and describe the evidence on implementation of RGM among adults with Type 1 or Type 2 diabetes in U.S. safety-net settings.
Methods:
The scoping review will be conducted in accordance with Joanna Briggs Institute (JBI) methodology and reported using PRISMA-ScR guidelines. The protocol was registered with the Open Science Framework on August 26, 2026. We will search PubMed, Web of Science, CINAHL, Scopus, and Cochrane databases. We will also search gray literature sources like conference proceedings, dissertations, and clinical trials. Two reviewers will independently screen papers in two phases. Phase one will be a title/abstract screening and phase two will be a full-text screening. Disagreements will be resolved by group consensus. Data will be charted using a standardized extraction form in Covidence. The form will include study and source characteristics, population and setting characteristics, implementation strategies and workflows, RGM technology characteristics, implementation strategies and outcomes, clinical outcomes, barriers and facilitators, and health equity characteristics. Findings will be synthesized using descriptive statistics and narrative synthesis.
Results:
The scoping review began in June 2026 and is currently in progress. As of August 2026, title and abstract screening for peer-reviewed literature has been completed. Gray literature search and full text screening is planned for September 2026.
Conclusions:
This review will provide the first comprehensive synthesis of RGM implementation approaches, challenges, and success in U.S. safety-net settings. Findings will highlight barriers and facilitators for patients, providers, organizations, and policy, as well as gaps in addressing health equity considerations. Findings will inform clinicians, researchers, and policymakers seeking to implement RGM more effectively and equitably. Clinical Trial: Open Science Framework 10.17605/OSF.IO/UKR4W
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