Background: CGM devices have been shown to improve glycemic control in patients with T1D. Despite existing clinical evidence and improved performance of CGM devices, only a small proportion of patients are using CGM.
Methods: The T1D Exchange QI Collaborative (T1DX-QI) is a large cohort with twelve national clinics engaged in data sharing and quality improvement to improve outcomes. This analysis used the T1DX-QI database to examine patient attributes associated with CGM device use. Patients with one or more completed clinic encounters during the years 2017-2019 were included (N=16,414) and classified as CGM users if they indicated information on a device start date, model or company within the past one year of their most recent diabetes clinic visit. We examined the frequency of CGM device use and distribution of socio-demographic factors, as well as clinical outcomes, among CGM users versus non-users.
Results: In this cohort, 27.4% of T1D patients were CGM users, with patients aged ≤26 years being more likely to use CGM. Among CGM users, 75% used a real-time device, a 3% intermittent scanning device, and 22% device type was unknown. CGM use was more likely among Non-Hispanic Whites (75%) and patients on private health insurance (72%) relative to Non-Hispanic Black patients (3%) and those on public health insurance (27%) [p<0.001]. HbA1c levels among CGM users were lower relative to non-users after adjusting for age, race/ethnicity and insurance status (8.3%± 1.7% vs. 8.8%±1.9%) [p<0.001].
Conclusion: This study highlights patient factors and clinical outcomes among CGM users in the T1DX-QI Collaborative, one of the largest sources of real world data for T1D available to-date. The findings shed light on socio-demographic variability in CGM uptake with implications for targeted interventions to promote device use in this subset of the T1D population.
N. Noor: None. N. Rioles: None. S. Majidi: Advisory Panel; Self; Companion Medical. S. Corathers: None. R. McDonough: None. S. Polsky: None. M. Greenfield: None. K. Obrynba: None. O. Ebekozien: None. D. DeSalvo: Consultant; Self; Dexcom, Inc., Insulet Corporation.
The Leona M. and Harry B. Helmsley Charitable Trust