In an interview with Pharmacy Times for the 2026 Diabetes Day of Education, Nicole C. Pezzino, PharmD, BCACP, CDCES, director of community outreach & innovation at Wilkes University Nesbitt School of Pharmacy and director of clinical and technical services at Red Cell Technologies, discussed the critical role community pharmacists can play in supporting patients with diabetes who use continuous glucose monitoring (CGM) technology.
Pezzino identified 3 core gaps limiting pharmacist involvement: workflow and time constraints, a lack of reimbursement models for CGM education services, and gaps in pharmacist confidence. She emphasized leveraging the trusted patient-pharmacist relationship to make CGM data approachable through plain-language, personalized conversations focused on progress over perfection. Pezzino also shed light on an underexamined barrier to long-term CGM persistence—the emotional and identity-related toll of wearing a visible device—and offered a patient case example illustrating how pharmacist-guided, data-driven experimentation can drive meaningful behavior change.
Pharmacy Times: What gaps are you still seeing in how community pharmacists are equipped to support CGM users?
Nicole C. Pezzino, PharmD, BCACP, CDCES: That's a great question. Some of the biggest gaps that I see for community pharmacies in supporting patients with technology or CGM use really fall into 3 areas. We think about the obvious: the time constraints in workflow. We also can think about pharmacists having that reimbursable opportunity to provide these services to patients and then maybe some of the confidence within the community pharmacy setting. We know, community pharmacists—it’s been shown over and over again—that we're the most accessible health care provider. We're the people that patients come to for really any questions. Being able to have an avenue where pharmacists could be reimbursed for the time that they're giving patients with this education just isn't there yet.
Another piece of it, of course, is that time constraint. In terms of that reimbursable model and the time it takes to educate patients, it might not be matching up right now. What we do have, though, is fantastic relationships with patients. When we think about how we can leverage those relationships to connect patients to resources and tools, or just thinking about how we can bridge that gap—okay, maybe they don't have the time, but how can we help with that education piece in the 3- to 5-minute interaction that I do have with that patient?
Pharmacy Times: What communication strategies have you found most effective for translating complex CGM data trends into language that resonates with patients?
Key Takeaways
- Community pharmacists lack a reimbursable pathway for CGM education, but the 3-to-5-minute patient interaction remains a powerful and underutilized touchpoint.
- Translating CGM data effectively means ditching clinical jargon. Lead with curiosity, ask patients to walk you through their day, and reinforce progress over perfection.
- The emotional and social visibility of wearing a CGM is a real and underaddressed barrier to long-term persistence that pharmacists should proactively acknowledge with patients.
Pezzino: When we look at the CGM data that we get, there's so much incredible information that we can pull from it. Community pharmacists have those relationships with patients. Patients don't necessarily need a lecture on the data, right? They need a human and that relationship to simplify those complex data trends. I think we often underestimate the emotional toll that diabetes has because now you have access to all this data—the highs and the lows. There are so many complex pieces, so that human component can really be a nice way to break down that communication and help the patient understand what the data means. I look at it and talk to my patients. I'm not saying to them, “Your glycemic excursions”—that sounds scary. If we break it down to “What do you notice when you eat this?” or “What happened? Walk me through this day when your numbers looked like this,” they'll tell me. Sometimes it's just saying, “Great job.”
With the pattern, we're looking more at progress over perfection in the data with the patient, reinforcing all the really great changes and that empowerment of knowledge that they have. Keeping it simple, keeping it personal, knowing their relationships—because in that community setting, I can't say this enough: that relationship piece matters. I know if my patients are going to celebrate a really big achievement with their family one night, so I take that into consideration and am like, “That's incredible that you had that opportunity to do that,” and then also help bring awareness to what that means to their diabetes and encourage them with that progress rather than perfection.
Pharmacy Times: What are barriers on the patient side to long-term CGM persistence that don't get talked about enough?
Pezzino: We talk very often about insurance coverage and cost. I think something that's not always talked about is the behavioral and emotional toll that comes with CGM. I'm going to start this one off with a story. I remember when we first started using CGMs more, and I was working with a company and got one put on to try it and be able to educate patients more effectively. I put it on, and I started going to my gym and working out. Someone at my gym came up to me and said, “I didn't know you had diabetes.” I was like, “What do you mean?” She pointed to my arm, and I said, “Oh my gosh, I didn't even think of that.” Then I was shopping at the grocery store, and someone came up to me and said, “My dad has diabetes too.” I remember feeling like, “Huh, that's very interesting that you're saying that to me.” Then I started reflecting on how someone with diabetes would feel about these conversations.
I do think a lot of those barriers are starting to come down in the era of influencers, and they're putting it on more for wellness—to get more data into how food affects glucose or sugars, how exercise affects it, how stress affects it. When you have a stressful situation, you could see a glucose spike happen. I do think a lot of that is being broken down. But I think me having that experience firsthand and seeing how that visibility becomes your identity—you’re wearing this, now people see it, and now they're going to start asking you questions about it—I found that to be a very interesting experience as someone without diabetes. When I think of someone with diabetes maybe experiencing that more often, I can only imagine how that would impact them.
On the flip side, though, I had a patient once come in, and, having this data, we were able to work together. He was like, “Okay, I don't know why my sugars are spiking so high in the morning. It makes no sense.” He was only doing blood glucose monitoring at the time, so he shared with me, “Okay, I have a blueberry muffin for breakfast with some nuts, and I'm not changing it. I'm 70 years old. This is going to be my breakfast forever.” I was like, “Okay.” We were able to talk to him about maybe putting a CGM on and seeing what happens if he walks after eating it. We did some small studies with him—we called it that together because he really liked that piece of it. The next day, he was like, “Okay, this is what I did after,” and it didn't really affect it. I said, “Okay, what if you eat half a blueberry muffin tomorrow and then pair it with some eggs?” He did that and looked at his numbers. We were able to do little experiments to see how that would affect his blood glucose and impact him, and he was shocked to see that eggs with a blueberry muffin didn't increase it as much. We'll talk to people about how, yes, there's that piece of identity and maybe some stigma associated with wearing the CGM, but here are some ways that it can help you and how we can look at it together.
