Visual Abstract

Background: The management of type 1 diabetes (T1D includes aiming to achieve optimal glucose management to avoid complications, but this remains a challenge.)

Aim: To identify factors related to optimal glycemic management (A1c <7.0%) in adults in the T1DX-QI, a United States quality improvement multicenter learning network.

Methods: The analysis included 8,062 T1D adults (18 - 65 years) in the T1DX-QI database for whom electronic medical record data were available, with at least one completed clinic encounter July 2017 - February 2020.

Results: In this population (age range 18 to 65 years), 20% (N=1,609) of T1D adults had optimal glycemic management (A1c <7.0%, see Table). Worse glycemic management was associated with being Non-Hispanic Black, having public insurance, older age, obesity, and hyperlipidemia. CGM use with or without insulin pump use, but not pump use without CGM, were associated with better glycemic management.

Conclusion: These real-world data highlight racial disparities, the difficulty achieving A1c <7.0% in adults with T1D and suggest that CGM use is beneficial. Better approaches for achieving optimal glycemic management in T1D adults are needed.


N. Rioles: None. S. Polsky: Advisory Panel; Self; Medtronic, Consultant; Self; National Institutes of Health, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, JDRF, Medtronic, National Institute of Diabetes and Digestive and Kidney Diseases, Sanofi US, T1D Exchange. O. Ebekozien: None. N. Noor: Research Support; Self; Dexcom, Inc. F. Vendrame: None. M. Basina: None. R. S. Weinstock: Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc.


The Leona M. and Harry B. Helmsley Charitable Trust

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