Background <p>Technology such as continuous glucose monitors (CGMs) have the potential to dramatically improve diabetes care for people with type 2 diabetes (T2D), but optimised clinical support is also required. This study aims to explore the use of a new kaiāwhina (cultural support worker)-based model of T2D healthcare delivery, with and without the use of CGM, as models of care that can be implemented long-term into primary care.</p> Methods <p>This randomised controlled trial will be conducted within one geographical region (Waikato, New Zealand), and will be delivered by two general practice clinic providers (covering seven different clinic sites). A minimum of 90 adults with T2D with suboptimal glycaemic control (HbA1c &gt; 9.5% [80 mmol/mol]) will be assigned by randomisation with minimisation to one of three trial arms for a period of 26 weeks. Intervention 1 consists of intermittant use of CGM plus kaiāwhina plus optimised nurse/prescriber-based clinical care. Intervention 2 consists of kaiāwhina plus optimised nurse/prescriber-based clinical care without CGM. The third arm consists of Usual Care i.e., patient-initiated clinic visits as required and any standard practice-initiated interaction with patients such as recall for medications and diabetes annual review. At 26 weeks, patients from Usual Care will be randomised with minimisation into either Intervention 1 or 2 for a further 26 weeks. The primary outcomes of the study are change in HbA1c at 26 weeks in both Intervention 1 and 2 versus Usual Care. Secondary outcomes include change in HbA1c between Intervention 1 and Intervention 2 (including those assigned to each intervention after completing the Usual Care arm), changes in HbA1c and cardiovascular measures at 12 and 26 weeks, changes in psychosocial test scores (DSMQ, PAID-II and PHQ), cost-effectiveness analysis (cost per quality-adjusted life-years) and targeted interviews with participants and clinicians to explore their respective experiences and perspectives of the two intervention arms.</p> Discussion <p>This trial has the potential to inform longer-term primary management of T2D, including the efficacy of both optimised clinical activity and technology use to support people with high-risk glycaemia in an equity-centred model of care.</p> Trial registration <p>The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12624000438550) on 10th April 2024.</p>