723-P: Patient-Reported Barriers to Continuous Glucose Monitor Usage Free

Aims: What are patient reported barriers to continuous glucose monitor (CGM) use in the pediatric type 1 diabetes population?

Methods: Recruited patients with type 1 diabetes of ≥6 months at Harold Schnitzer Diabetes Health Center filled out a survey regarding their current glucose monitoring system. The survey incorporated the GMSS-T1D¹ and qualitative sections to assess patient's satisfaction, experience, quality of life, and barriers of using CGM and standard glucometers (SGM). Caregivers of patients younger than 15 years were surveyed with verbal assent from patients who were ≥7 years. Duration of diabetes, A1c, and type of insurance were also studied.

Results: 114 patients were recruited with 69 patients completing the study. Ages ranged from 3 - 19 years, with a mean age of 12.6 years. 70% were CGM users and 30% SGM users. 64% of current SGM users had CGM use in the past. 28% of current CGM users reported difficulties using the CGM. Reported difficulties were grouped into categories; healthcare system related, physical, difficult to use, trust, and device malfunction. The most common difficulty among current CGM users was in regards to obtaining the device related to cost, delivery, and replacements. Past CGM users reported the same difficulty obtaining the device and difficulty using the device as top reasons for not using CGM. Overall current CGM users had higher satisfaction scores on the GMSS and better A1c than SGM users.

Conclusion: CGM users reported higher satisfaction with their device and better control of their diabetes. Current CGM users reported difficulties with cost, unreliable delivery of refills and replacements, and physical barriers including limited sites, pain and bleeding. Past CGM users reported additional barriers with device malfunction and not liking it.