359-OR: Variation in Utilization of Continuous Glucose Monitoring in Patients with Type 1 Diabetes

Background: Continuous glucose monitoring (CGM) is recommended by the American Diabetes Association for patients with type 1 diabetes (T1D) but remains underutilized. Prior studies suggest ~30% of patients with T1D use CGM with variation by race/ethnicity reported.

Methods: We used electronic health record data from an academic medical center (1/1/2018-12/31/2021) to examine variation in CGM utilization in patients with T1D and describe demographic factors associated with CGM use via multivariate logistic regression adjusted for clinical variables outlined in Table 1.

Results: Among 3,382 patients with T1D (aged 28.6 ± 17.8 y; 51% female; 83% non-Hispanic White), 52% used CGM during study period. CGM utilization was significantly lower in older (age 65+) versus younger patients (age 0-13; OR=0.15, 95% CI: 0.09, 0.26), Hispanic versus non-Hispanic White patients (OR=0.44, 95% CI: 0.21, 0.94) and patients with commercial versus government-issued insurance coverage (Medicaid, OR=0.44, 95% CI: 0.37, 0.52; Medicare, OR=0.42, 95% CI: 0.30, 0.50).

Conclusions: In this population of patients with T1D, 1 in 2 patients used CGM to manage their diabetes but there was significant variation. Identifying populations with lower-than-expected utilization is a necessary first step in developing targeted interventions to increase CGM uptake and, ultimately, improve short and long-term T1D-related outcomes.

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