Patient Demographics and Clinical Outcomes Among Type 1 Diabetes Patients Using Continuous Glucose Monitors: Data...

Area of Science:

• Endocrinology
• Diabetes Management
• Health Disparities

Background:

• Continuous Glucose Monitoring (CGM) offers significant benefits for glycemic management in type 1 diabetes.
• Widespread adoption of CGM technology remains a challenge despite proven advantages.
• Real-world data is crucial to understand patient characteristics and outcomes related to CGM use.

Purpose of the Study:

• To investigate patient attributes associated with CGM use in type 1 diabetes.
• To evaluate clinical outcomes, including glycemic control and adverse events, in CGM users versus non-users.
• To identify sociodemographic disparities in CGM uptake within a US-based collaborative.

Main Methods:

• Analysis of electronic health record data from eight US endocrinology clinics.
• Inclusion of 11,469 patients with type 1 diabetes from the T1D Exchange Quality Improvement (T1DX-QI) Collaborative (2017-2019).
• Comparison of CGM usage rates, HbA1c levels, and rates of diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) between CGM users and non-users.

Main Results:

• 48% of type 1 diabetes patients utilized CGM.
• CGM use was lower among Non-Hispanic Blacks (18%) and Hispanics (38%) compared to Non-Hispanic Whites (50%).
• Patients with private insurance (57.2%) were more likely to use CGM than those with public insurance (33.3%).
• CGM users exhibited lower median HbA1c (7.7% vs. 8.4%) and significantly lower rates of DKA and SH compared to non-users.

Conclusions:

• CGM use is associated with improved glycemic control and reduced severe hypoglycemia and DKA in type 1 diabetes.
• Significant sociodemographic disparities exist in CGM uptake, particularly concerning race/ethnicity and insurance status.
• Targeted quality improvement initiatives and advocacy are needed to promote equitable CGM access and utilization.