- ✓Combines CGM technology with personalised cultural support for a whole-person approach to diabetes care
- ✓Targets people with very poor blood sugar control (HbA1c >9.5%) who need the most help
- ✓Equity-centred model could improve care access for underserved and minority communities
| Journal | BMC health services research |
| Year | 2025 |
| Authors | Chepulis, van Zyl, Moorhouse |
| PMID | 41029658 |
What Was Studied and Why It Matters
Managing type 2 diabetes is about more than medication — it takes the right tools, the right support, and care that fits your life and culture. Researchers in New Zealand are running a clinical trial called TEKNO to find out whether combining continuous glucose monitors (CGMs) with cultural support workers (called kaiāwhina) can dramatically improve blood sugar control for people whose diabetes is not well managed.
This matters because many people with type 2 diabetes — especially those from underserved or minority communities — struggle to keep their blood sugar in a healthy range, even with standard medical care. New models of care that bring together technology and human connection could change that.
How the Study Works
At least 90 adults with type 2 diabetes and poor blood sugar control (HbA1c above 9.5%) are being enrolled across seven clinic sites in the Waikato region of New Zealand. Participants are randomly placed into one of three groups for 26 weeks:
- Group 1: CGM use + a kaiāwhina cultural support worker + optimised nursing and prescriber care
- Group 2: A kaiāwhina cultural support worker + optimised nursing and prescriber care (no CGM)
- Group 3 (Usual Care): Standard clinic visits as needed — the way most people currently receive diabetes care
After 26 weeks, people in the usual care group are then moved into one of the two intervention groups for another 26 weeks. This design helps researchers understand the true benefit of each approach.
What Researchers Are Looking For
The main goal is to see how much each approach lowers HbA1c — a key blood test that reflects average blood sugar over roughly three months. But researchers are also tracking:
- Heart health measures
- Mental health and diabetes distress scores
- Cost-effectiveness (how much benefit per dollar spent)
- Patient and clinician experiences in their own words
What This Could Mean for Patients
If CGMs prove effective in this setting, it would support wider access to real-time glucose monitoring for people with type 2 diabetes — not just those using insulin. CGMs take the guesswork out of blood sugar management by showing you exactly how food, activity, and stress affect your levels throughout the day. For patients managing supplies, resources like MDS Diabetes can make accessing CGMs and other diabetes management tools more convenient and affordable.
Equally important is the kaiāwhina model — having a culturally matched support worker who understands your background and can bridge the gap between clinical advice and everyday life. This kind of personalised, equity-focused care could be a game-changer, especially for communities that have historically been underserved by the healthcare system.
Bottom Line
This New Zealand trial is testing a promising new team-based care model that pairs continuous glucose monitors with cultural support workers to help people with hard-to-control type 2 diabetes. Results could reshape how primary care is delivered — not just in New Zealand, but anywhere people need more than a standard clinic visit to truly manage their diabetes well. Watch this space: findings from TEKNO could open doors to better, more personalised care for thousands of people.