Introduction & Objective: There is a growing body of evidence supporting continuous glucose monitor (CGM) use in adults with Type 2 Diabetes (T2D), and recent evidence to suggest CGM use could also be beneficial to adolescents and young adults (AYA) with T2D. CGM use is presently limited in this population and a deeper assessment is needed to understand barriers to use. The objective of this study was to determine baseline CGM use in AYA with T2D cared for by the UW Health Pediatric Diabetes Clinic.
Methods: All individuals with T2D seen at least once by the UW Health Pediatric Diabetes Clinic since 2016 were included in this observational study. Electronic medical records were reviewed to collect pertinent demographic, laboratory, and diagnosis information, as well as, any documentation regarding barriers to receiving or using CGM. Parameters were compared between groups using t-test or nonparametric test, as appropriate.
Results: Of the AYA with T2D seen, 156 had complete information and were included. Per chart review, 17 of the 156 AYA were using CGM. There was no statistical difference in mean hemoglobin A1C at diagnosis between groups. When considering insurance coverage, 54% of those using CGM and 66% of those not using CGM reported having Medical Advantage (MA) or other managed plan. AYA with T2D reported various barriers to starting and using CGM including not wanting to wear something that would draw attention to themselves, prohibitive costs, and difficulty obtaining insurance coverage. Notably, for some AYA with T2D who were using CGM, the aforementioned issues continued after CGM initiation.
Conclusion: CGM use in AYA with T2D is limited for a variety of reasons. Understanding individual’s personal feelings around CGM will be helpful to determine how CGM use can be incorporated into their diabetes care. Insurance coverage of CGM for AYA with T2D was found to be variable. The role of CGM in the care and management of T2D in AYA continues to evolve; further exploration is needed to understand and address perceived barriers.
R. Fenske: None. E.A. Mann: None.
