Pharmacists play a vital and growing role in managing diabetes care. By collaborating with healthcare providers and patients, pharmacists ensure safe, effective care in settings such as on-site clinics and via telehealth, often under collaborative drug therapy management (CDTM) agreements. Patients managed by pharmacists are typically able to receive more frequent follow-up encounters than those managed by providers alone, allowing for timely medication adjustments and faster achievement of treatment goals.1

Beyond diabetes, pharmacists routinely manage an array of related chronic conditions, such as hypertension, obesity, and chronic kidney disease.1 This multifaceted involvement highlights the pharmacist’s essential role in optimizing outcomes for persons living with diabetes. Pharmacist-led, patient-centered care includes:

  • enhancing pharmacotherapy and safety
  • assisting with interpreting and acting on blood glucose monitoring data
  • bridging gaps in access to diabetes supplies
  • providing education and highly accessible clinical services

Enhancing Pharmacotherapy and Safety through Pharmacist-Led Care

Pharmacists play a key role in individualizing medication management in persons with diabetes by providing education, optimizing pharmacotherapy, promoting adherence, and minimizing adverse effects. Once limited to traditional dispensing roles, pharmacists have integrated into more patient-facing clinical responsibilities and prescribing authority through collaborative practice agreements (CPAs) . CPAs are arrangements between pharmacists and other healthcare providers that authorize them to perform specific clinical services such as initiating, modifying, or discontinuing medications, ordering labs, or performing patient assessments. This expanded clinical role ensures complete patient care experience that enhances medication management, outcomes, safety, and continuity of care.

Patients often face challenges that can complicate adherence to oral medication regimens. To mitigate this, pharmacists can implement changes such as recommending combination drugs or offering extended-release formulations, which are often better tolerated. Additionally, pharmacists, under a CPA or by making a direct recommendation to the provider, can monitor and adjust doses of anti-hyperglycemic medications to reduce side effects and other complications. They can also evaluate medication appropriateness based on comorbidities such as impaired renal function or congestive heart failure.

One of the biggest barriers to initiating certain regimens for diabetes treatment is patient fear of needles. As injectable therapies other than insulin – such as glucagon-like peptide-1 receptor agonists (GLP-1RA) and GLP1-RA/glucose-dependent insulinotropic polypeptide (GIP) agonists – become increasingly central to diabetes management, pharmacist-led counseling on proper injection techniques helps overcome injection anxiety and empowers patients to self-manage their diabetes. Pharmacists also assist in missed dose management, and they often have greater bandwidth than other clinicians for timely follow-up visits to address side effects, titrate medications, and optimize pharmacotherapy to achieve target A1c levels.

From Device Selection to Data Interpretation: Pharmacists in Glucose Monitoring

Diabetes management has evolved far beyond finger sticks and logbooks. Today, patients have access to a wide range of tools, including advanced continuous glucose monitoring (CGM) devices that provide real-time insights into blood sugar patterns. As one of the most accessible healthcare professionals, pharmacists are uniquely positioned to support patients in making the most of these tools. Studies have shown that pharmacist-led diabetes monitoring in ambulatory care settings is associated with improvements in A1c reduction and increased time in range (the percentage of time blood sugar levels stay within a healthy target goal).3

Regularly monitoring blood glucose empowers persons living with diabetes to better self-manage their condition. CGM data helps patients understand how different factors, such as food, exercise, stress, and medication, can affect glucose levels in real time. In turn, patients can adjust lifestyle choices, minimize complications, and work with their healthcare team to personalize treatment decisions. Pharmacists interpret glucose data to identify patterns of hypoglycemia or hyperglycemia related to medication timing or dosing, recommend changes to clinicians, initiate adjustments to medications with or without CDTM agreements, and reinforce adherence.

The American Diabetes Association (ADA) recommends that CGM devices be offered to all patients with diabetes on insulin.2 Pharmacists have the opportunity to work closely with patients to ensure they have the proper education and support in choosing the right monitoring system based on lifestyle and comfort level, evaluating insurance coverage and reviewing available options, and assessing and comparing cost. As patients learn to fit glucose monitoring into their daily routines, pharmacists can ease the burden by assisting with:

  • Detailed, patient-specific education
  • Initial set-up and explanation of device-specific tools
  • Sensor insertion safety
  • Calibration and troubleshooting
  • Interpreting data, such as fasting versus post-prandial results

Rapid advances in diabetes-related technology make it challenging for the healthcare system to stay current with the most effective options, navigate changes in insurance coverage, and promote high-quality educational resources. Pharmacist-led care is essential to guide informed decision-making for patients.

Bridging Gaps to Access Diabetes Supplies

For persons living with diabetes, having access to the appropriate supplies is just as critical as access to medication. Despite this, many patients encounter barriers due to cost, insurance challenges, and limited knowledge of available supply options, especially after a recent diagnosis. Pharmacists are uniquely positioned to address urgent questions and educate patients and prescribers about test strips, lancets, lancing devices, alcohol swabs, glucometers, CGMs, insulin pumps, pen needles, and syringes. Pharmacists are also key to:

  • Insurance coverage: Pharmacists identify covered products and switch to alternatives when applicable. They work with prescribers to optimize prescriptions based on formulary coverage and navigate prior authorization processes.
  • Safety, storage, and proper disposal: Pharmacists counsel on the correct use of diabetes supplies by demonstrating proper injection technique with pens or syringes, educating on lancet device use and test strip storage, training on use of CGMs, and reinforcing best practices for infection control and needle disposal.

Preventative Health Education

Pharmacists play a critical role beyond pharmacotherapy with preventative health education, counseling on lifestyle modifications and essential health checks. They screen and identify people who are at high risk for diabetes and other complications by reviewing blood glucose levels, family history, medication history, and other lifestyle factors.

Pharmacists in clinics can recommend bloodwork to monitor A1c, lipids, and kidney function to identify common comorbidities, such as cardiovascular disease, nephropathy, and retinopathy.4 Uncontrolled blood pressure (BP) and high cholesterol lead to cardiovascular complications that can often be prevented. Pharmacotherapy and lifestyle counseling can help people with diabetes reach their goal BP and cholesterol levels. If patients develop nephropathy, pharmacists can recommend medications to promote renal protection, monitor for worsening kidney function, and adjust the dose of medications.

Pharmacists assist in holistic disease-management strategies encompassing a variety of activities, including helping patients obtain BP monitors and use them correctly, encouraging healthier eating habits, promoting physical activity and stress management, tracking body weight and body mass index, and offering smoking cessation counseling and treatment. Pharmacists also help identify and close care gaps to ensure that routine health screenings are completed to prevent other complications by:

  • Initiating patient outreach and coordinating provider referrals to ophthalmologists for annual eye exams
  • Recommending routine foot exams to monitor new or worsening neuropathy
  • Counseling, maintaining, and administering recommended immunizations to reduce the risk of infections, hospitalizations, and mortality

Accessibility of Phrmacists Clinical Services

Technology allows pharmacists to be more accessible than ever. As part of our diabetes management services at Shields Health Solutions, provided by integrated health system specialty pharmacies, we offer a 24/7 toll-free clinical services phone line staffed by our highly trained clinical pharmacists. Our integrated care model also allows for seamless communication between pharmacy liaisons and the Patient Support Center to help resolve financial and insurance-related barriers when clinical pharmacists step in to make recommendations to providers. Whether it’s a medication-related question, insurance problem, or just someone looking for support, we are readily available to persons living with diabetes.

Our frequent patient touchpoints have contributed to high medication adherence rates, measured by the proportion of days covered (PDC), and patient satisfaction, especially for patients taking GLP1 RA/GIP medications. Patients enrolled in our clinical services program had an overall PDC ranging from 88-98% for the specified injectable GLP1 and GLP1/GIP agonists, well above the widely accepted threshold of 80% for adequate adherence.5 Having a pharmacist just a call away showcases the impact of our diabetes management program and its ongoing success. An integrated model for diabetes care optimizes management and patient engagement for this complex and chronic disease.

Conclusion

Pharmacist-led diabetes management programs individualize treatment, achieve enhanced patient outcomes, and close care gaps by providing high-quality care and alleviating clinical workload for other healthcare providers.1 Pharmacists enhance comprehensive diabetes care through pharmacologic treatment, nonpharmacological counseling, and preventative health strategies that address unmet needs for underserved patients, deliver holistic care, reduce the risk of complications, and empower patients to self-manage their disease state. The accessibility of pharmacists to people with diabetes helps improve medication adherence, optimize therapeutic outcomes, and enhance overall quality of care.

References
  1. Orabone AW, Do V, Cohen E. Pharmacist-Managed Diabetes Programs: Improving Treatment Adherence and Patient Outcomes. Diabetes Metab Syndr Obes. 2022 Jun 20;15:1911-1923. doi: 10.2147/DMSO.S342936. PMID: 35757195; PMCID: PMC9231415.
  2. American Diabetes Association Professional Practice Committee. Diabetes technology: standards of medical care in diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S146–S166. https://doi.org/10.2337/dc25-S007
  3. Vascimini A, Saba Y, Baskharoun F, Crooks K, Huynh V, Wasson S, Wright E, Bullers K, Franks R, Carris NW, Cowart K. Pharmacist-driven continuous glucose monitoring in community and ambulatory care pharmacy practice: A scoping review. J Am Pharm Assoc (2003). 2023 Nov-Dec;63(6):1660-1668.e2. doi: 10.1016/j.japh.2023.07.010. Epub 2023 Aug 2. PMID: 37541390.
  4. Henry TM, Smith S, Hicho M. Treat to goal: impact of clinical pharmacist referral service primarily in diabetes management. Hosp Pharm. 2013 Sep;48(8):656-61. doi: 10.1310/hpj4808-656. PMID: 24421536; PMCID: PMC3847985.
  5. Shields Health Solutions. GLP-1 Medications: Improving Access and Adherence. Shields Health Solutions website. https://shieldshealthsolutions.com/glp1-wp-lp/. Published April 2, 2025. Accessed October 7, 2025.