DeSalvo, DJ, Lanzinger, S, Noor, N, Steigleder-Schweiger, C, Ebekozien, O, von Sengbusch, S, Jones, NH, Laubner, K, Maahs, D, Holl, RW

The utility of CGM to improve glycemic control and QoL is well established; however, real-world use of CGM varies among people with T1D. The objectives of this study were to analyze the rates of CGM use and association to glycemic control (A1c) in the U.S. T1DX-QI Collaborative and the German-Austrian DPV Initiative. EMR data were analyzed for 15,113 T1DX-QI patients and 41,640 DPV patients with clinic visits in 2019.

Mean age for T1DX-QI patients was 19.6 13.2 yrs, 48.7% were female, and A1c was 8.6 2.0%. Among DPV patients, mean age was 21.9 18.0 yrs, 46.9% were female, and A1c was 7.7 1.4%. Overall CGM use in T1DX-QI was 53.3% with highest rates in adults (age distribution <6 yrs: 51.1%, 6-<12 yrs: 50.1%, 12-<18 yrs: 38.6%, 18-<25 yrs: 40.4%, 25-<50 yrs: 67.4%, 50-<65 yrs: 62.0%, >65 yrs: 55.7%). For DPV, overall CGM use was 56.3% with highest rates in pediatrics (age <6 yrs: 70.4%, 6-<12 yrs: 72.5%, 12-<18 yrs: 67.4%, 18-<25 yrs: 46.9%, 25-<50yrs: 22.5%, 50-<65 yrs: 21.5%, >65 yrs: 18.0%). A1c was lower in CGM users compared to non-users across all age groups in both T1DX-QI and DPV patients (Figure).

In this transatlantic comparison, CGM use in patients with T1D was associated with lower A1c in both registries, but rates of CGM use varied across age groups. Quality improvement initiatives and advocacy efforts to improve health policy are needed to promote more widespread uptake of CGM worldwide.

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