Preparing practice-ready pharmacists

In recognition of National Diabetes Awareness Month, more than 50 student pharmacists gathered recently in a classroom on UC Irvine’s campus, attaching penny-sized glucose sensors to the back of their arms. Each device contains a thin, flexible filament that sits just under the skin and quietly collects glucose readings every minute. For the next 15 days, the students would live with the same wearable technology increasingly used by people with diabetes and which, as UC Irvine research has shown, can be potentially life-changing for millions of Americans at risk for the disease.

Such technology is reframing how we think about diabetes prevention. The wearable glucose sensors not only help patients but help train the next generation of healthcare professionals. The need is urgent. In Orange County alone, 10 percent of adults have diabetes, and another third are considered prediabetic. Those with diabetes face more than double the medical expenses of those without it.

In an earlier UC Irvine-led study, adults with prediabetes who normally have no access to continuous glucose monitors wore the devices for 28 days. Seeing their glucose responses in real time prompted measurable lifestyle changes: more gym visits, reduced late-night snacking and healthier food choices.

“Symptoms of prediabetes and diabetes often go unnoticed,” says Joyce Lee, Pharm.D., a health sciences clinical professor and a certified diabetes care and education specialist who led the study. “But real-time feedback helps make the invisible visible.”

Building on that success, Lee and her team launched a first-of-its-kind initiative: integrating hands-on CGM training into UC Irvine’s core Doctor of Pharmacy curriculum. Few pharmacy programs in the country offer experiential CGM education, while even fewer require it.

The new approach is backed by a peer-reviewed UC Irvine study of students wearing the monitors. The findings, published this year in Pharmacy, show the impact of giving students firsthand experience:

• 94 percent recommended integrating hands-on CGM training into the Pharm.D. curriculum.
• Confidence in coaching patients on CGM use jumped from 30 percent to 85 percent.
• 82 percent said that the use of CGM was not as complicated as they had imagined.
• 73 percent reported healthier personal behaviors after wearing a sensor.

Students said the experience helped them better understand interstitial glucose readings, lag time after meals or exercise, sensor accuracy and app-based tools such as time-in-range, daily pattern and glucose management indicators.

They started with the basics: CGMs measure interstitial fluid, not blood glucose; they provide continuous data, not just single snapshots; and they can vary in features such as waterproofing, connectivity and wear time. The students also learned about medication interactions, sensor placement and when fingerstick checks are still needed.

Then came the hands-on part – cleaning the skin, placing the sensors, connecting to the sensors and interpreting their own glucose patterns.

Some were startled to see sharp spikes after common snacks. Others noticed dips during their morning commute. A few began adjusting their sleep schedules, hydration or meal timing.

“Experiential learning builds empathy,” Lee says. “Students feel what it’s like to wear a sensor, to check an app, to interpret a trend line. And that makes them better prepared to help and connect with people living with diabetes.”

CGMs, once used only by people with diabetes, are now revealing new possibilities for early detection, healthier behavior and more effective patient education. While over-the-counter CGMs became available for out-of-pocket purchase in 2024, insurance coverage is limited for people with prediabetes, as generally these sensors are not covered for preventive use or general wellness purposes. Many insurance plans continue to require insulin use or special circumstances, such as frequent hypoglycemia, in order to qualify for CGM coverage.

As the monitors become more common, pharmacists are increasingly on the front lines helping patients start them, troubleshoot data and make sense of glucose trends. Studies have shown that pharmacist-led CGM programs can reduce A1C levels, hypoglycemia events and even hospitalizations.

UC Irvine’s School of Pharmacy & Pharmaceutical Sciences is preparing its graduates for this responsibility by integrating hands-on CGM training into required therapeutics coursework, teaching far more than device operation. Student pharmacists learn how to guide patients through uncertainty, interpret patterns and navigate the often-emotional experience of seeing personal health data in real time – all beginning with a tiny filament under the skin that collects signals capable of altering the course of disease.