Continuous glucose monitoring (CGM) improves glycemic outcomes in children with type 1 diabetes (T1D) and is recommended for regular use. However, it is unclear how families use CGM and if they are using it to its greatest potential. In this study, 193 caregivers of children with T1D using CGM (mean age 9.3±2.8 years, 44% female, 10% ethnic minority, 92% using insulin pump) were recruited throughout the United States by social media to complete a cross-sectional survey about their real-time CGM use. Many children (70%) wore the sensor “all of the time,” with 77% using CGM ≥22 of the last 30 days. Most caregivers (93%) had a CGM feature to see their child’s data remotely in real time; 87% of those who used this feature viewed their child’s data at least once a day when their child was not with them. Though nearly all knew about CGM alert functions, only 73% set alerts for hyperglycemia and 80% for hypoglycemia “all the time.” Frequent retrospective review of CGM data was less common, with only 64% uploading and reviewing data at least monthly. Since starting CGM, most caregivers reported a decrease in their child’s glycated hemoglobin (A1c) (64%) and reduced frequency and severity of hypoglycemia (78%) and hyperglycemia (72%). In regression analysis (adjusted for age, duration of T1D, gender, minority status, caregiver education, geographic region, and pump use), younger age was associated with decrease in A1c (OR 0.78, 95% CI 0.67, 0.92) and decrease in hyperglycemia (OR 0.70, 95% CI 0.58, 0.84). Longer duration of CGM use was associated with decrease in hypoglycemia (OR 2.0, 95% CI 1.0, 4.1). Seventy-two percent reported CGM is “essential,” and 53% felt the greatest benefit is seeing data in real time.
In summary, caregivers utilize real-time CGM functions (remote monitoring, alerts) more frequently than they retrospectively review data. Future studies should focus on how caregivers use real-time and retrospective CGM data to make T1D management decisions in order to optimize use of the technology.
J.C. Wong: Advisory Panel; Self; Tidepool Project. Research Support; Self; Dexcom, Inc. F. Abdulhussein: None. B.J. Yeung: None. E.J. Velazquez: None.