There is a dearth of data to quantify the utilization of diabetes technology among the growing population of older adults with T1D. We assessed differences in the use of CGM between those receiving endocrine care versus those not. We analyzed electronic health record (EHR) data from a large, public health care system in the southeast US, including 12 affiliated hospitals and over 200 academic and community-based practices. We included data from adults ages 65+ years with T1D in 04/01/2019-2022. We used logistic regression to model the likelihood of using CGM among those who had a visit with endocrinology in the past year versus those who did not. We used entropy balancing weights to create an analytic sample that was balanced on covariates. Our sample included 560 older adults with T1D, comprised of 32% using CGM. Of CGM users, 43% had an endocrinology appointment and 22% did not. Those with endocrine care had higher odds of using CGM compared to those who did not (aOR: 2.38, 95% CI: 1.65, 3.45). In probability terms, those with an endocrinology appointment in the previous year had a 17.8 percentage point (95% CI: 9.9, 25.6) higher probability of using CGM than those who did not (Fig). In a regional sample, we found relatively low CGM utilization and disparities therein across the receipt of endocrine care among older adults with T1D. Limitations include data from one healthcare system only.
A.R.Kahkoska: None. J.M.Weinstein: Research Support; Dexcom, Inc. R.Muthukkumar: None. L.A.Young: Research Support; Novo Nordisk, Rhythm Pharmaceuticals, Inc., Eli Lilly and Company, Jaeb Center for Health Research, Sanofi, Boehringer-Ingelheim.
National Institutes of Health (KL2TR002490, UL1TR002489)