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CGM devices have been shown to improve glycemic control in patients with T1D. Despite existing clinical evidence and improved performance of CGM devices, only a small proportion of patients are using CGM.
The T1D Exchange QI Collaborative (T1DX-QI) is a large cohort with twelve national clinics engaged in data sharing and quality improvement to improve outcomes. This analysis used the T1DX-QI database to examine patient attributes associated with CGM device use. Patients with one or more completed clinic encounters during the years 2017–2019 were included (N = 16,414) and classified as CGM users if they indicated information on a device start date, model or company within the past one year of their most recent diabetes clinic visit. We examined the frequency of CGM device use and distribution of socio-demographic factors, as well as clinical outcomes, among CGM users versus non-users.
In this cohort, 5486 (33.4%) of T1D patients were CGM users, with patients aged ≤26 years being more likely to use CGM (48%). Among CGM users, about 60% used a real-time device, 2% used an intermittent scanning device, whereas for 38% device type was unknown. CGM use was more likely among Non-Hispanic Whites (75%) and patients on private health insurance (77%) relative to Non-Hispanic Black patients (2%) and those on public health insurance (20%) [p < 0.001]. HbA1c levels among CGM users were lower relative to non-users after adjusting for age, race/ethnicity and insurance status (8.0% ± 1.7% vs. 8.8% ±1.9%) [p < 0.001].
This study highlights real world evidence of patient factors and clinical outcomes among CGM users in the T1DX-QI Collaborative. This distribution of patient attributes comes from one of the largest T1D cohort’s available to-date and sheds light on sociodemographic variability in CGM uptake with implications for targeted interventions to promote device used in this subset of the T1D population.
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