Disparities in Continuous Glucose Monitor Prescriptions by Language Preference Among Adults With Type 2 Diabetes

Patients with a non-English language preference are less likely to be prescribed continuous glucose monitors (CGMs), highlighting ongoing inequities in diabetes care, according to findings published by investigators in JAMA Network Open.

The results add to previous evidence that suggests racial, ethnic, and language-based disparities in access to diabetes technology.^1,2

What Role Do CGMs Play in Diabetes Management?

Nearly 33.1 million US adults live with type 2 diabetes (T2D), and those with a non-English language preference (NELP) experience poorer health outcomes. CGMs, which are used to provide real-time glucose data through a sensor that sits under the skin, have been shown to improve hemoglobin A_1c (HbA_1c) levels and reduce diabetes-related health care use compared with traditional monitoring. The results are typically read through a wearable device or a cell phone app that allows the patient to track glucose levels in real time.^1,3

Despite the increased use of CGMs, prior studies have identified disparities in CGM access; however, data on the impact of language preference on access is limited.¹

What is the Impact of Language Disparities on CGM Access?

Researchers conducted a cohort study to compare CGM prescription rates between patients with NELP and those with English language preference (ELP) among adults with T2D that received primary care or endocrinology care from January 2022 to December 2023. A total of 69,269 patients were included with the primary end point of whether patients received a CGM prescription before December 31, 2023.¹

The analyses accounted for demographics, insurance type, insulin use, diabetes control, and type of care. Further analyses focused on patients with uncontrolled diabetes or insulin use and compared Spanish versus non-Spanish speaking patients with NELP.¹

Among the total participants, 12.1% had NELP, the median age was 60 years, and 43.5% had public insurance. Compared with ELP patients, NELP patients tended to be older, female, have Hispanic ethnicity, have public insurance, use insulin, and have uncontrolled diabetes but are less likely to see endocrinologists.¹

Overall, 12.2% of patients had at least 1 CGM prescription. Further findings suggested that patients with NELP were less likely to receive a CGM prescription compared to those with ELP (7.4% vs 12.7%; P < .001). This disparity remained significant and persisted among patients with uncontrolled diabetes and insulin use.¹

In the subgroup analyses, Spanish-speaking patients made up 60.5% of the NELP group and were generally younger, more often female, Hispanic, privately insured, insulin users, and had uncontrolled diabetes. However, CHM prescription rates did not significantly differ between Spanish- and non-Spanish-speaking patients.¹

“We found disparities in CGM prescriptions by language preference, showing patients with NELP having less access to CGM. These findings align with those of previous research documenting racial and ethnic disparities in CGM access. Our study highlights the specific role of language preference in CGM prescribing patterns,” the authors said in the study.¹

REFERENCES

1. Rodriguez JA, Prada-Rey N, Gao C, et al. Language Disparities in Continuous Glucose Monitoring for Type 2 Diabetes. JAMA Netw Open. 2025;8(6):e2516523. doi:10.1001/jamanetworkopen.2025.16523

2. Language disparities in continuous glucose monitoring for type 2 diabetes. News release. EurekAlert! June 17, 2025. Accessed October 24, 2025. https://www.eurekalert.org/news-releases/1087531

3. Cleveland Clinic. Continuous Glucose Monitoring (CGM). Updated May 24, 2024. Accessed October 3, 2025. https://my.clevelandclinic.org/health/articles/continuous-glucose-monitoring-cgm