# Implementation of a diabetes navIgator to Mitigate disPArities and improve CGM upTake and sustained use across the lifespan of T1D (IMPACT T1D)

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $481,328

## Abstract

Project Summary
 Type 1 diabetes (T1D) is a chronic disease that requires intensive daily management to maintain
adequate glycemic control and prevent diabetes-related complications. Less than 20% of individuals meet the
American Diabetes Association goal hemoglobin A1c level for adequate glycemic control. Use of diabetes
technologies, and specifically continuous glucose monitors (CGMs), are the standard of care, and improve
glycemic control, health related quality of life and treatment satisfaction. Despite these benefits, CGMs are
underutilized, particularly in minorities and individuals from underserved communities. Increasing uptake and
continued use of CGM can help improve glycemic control and mitigate disparities in diabetes-related outcomes
for underserved individuals.
 There are many barriers to CGM use at the patient, provider and systems levels, yet there are no
proven interventions to address these barriers. In a pilot study at our institution, we demonstrated that
placement of trial CGM with standardized education at the point of care increases CGM uptake, but
overcoming the knowledge barrier is insufficient to ensure personal and sustained use of CGM. The objective
of this project is to build upon our pilot study to implement a novel intervention in the real-world clinical setting
that is feasible, sustainable and generalizable to increase CGM uptake across the lifespan - including pediatric,
emerging adults, and adults with T1D.
 We hypothesize that implementing the support of a diabetes navigator with trial CGM placement
at the point of care will increase CGM uptake and sustained use, leading to improvements in glycemic
control that will mitigate disparities in diabetes related outcomes for underserved individuals with T1D.
In this proposal, we will first (Aim 1) refine the role and toolkit of the diabetes navigator based on stakeholder
feedback on solutions to address barriers to CGM uptake and sustained use. Building on the experience from
our pilot study, the formative phase of Aim 1, and leveraging the collective expertise of our multidisciplinary
study team, we will conduct a randomized controlled trial (Aim 2) of 136 individuals with T1D, including 60
children and adolescents and 76 adults, not currently using CGM. Participants will be randomized to (Arm 1)
standard of care trial CGM placement (n=68), or (Arm 2) the intervention arm with trial CGM placement with
the support from a diabetes navigator (n=68). We hypothesize that the diabetes navigator arm will have higher
CGM uptake and sustained use, with (Aim 3) greater improvements in glycemic control and patient-related
outcomes, compared to the standard of care arm. If the diabetes navigator is successful in increasing CGM
uptake and sustained use, and is demonstrated to be a feasible, acceptable and sustainable intervention that
can be applied to the larger diabetes community, it has the potential to improve diabetes care and mitigate
disparities in diabetes related outco...

## Key facts

- **NIH application ID:** 10898819
- **Project number:** 5R01DK134955-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** NESTORAS N MATHIOUDAKIS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $481,328
- **Award type:** 5
- **Project period:** 2022-09-21 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10898819

## Citation

> US National Institutes of Health, RePORTER application 10898819, Implementation of a diabetes navIgator to Mitigate disPArities and improve CGM upTake and sustained use across the lifespan of T1D (IMPACT T1D) (5R01DK134955-03). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10898819. Licensed CC0.

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