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HEMOGLOBIN A1C LEVELS AMONG PEOPLE WITH TYPE 1 DIABETES SWITCHING FROM SELF‐MONITORING OF BLOOD GLUCOSE TO REAL‐TIME CGM USE: A RETROSPECTIVE LONGITUDINAL STUDY
N. Noor1, E. Mann2, D. J. Desalvo3, J. Sanchez4, C. Levy5, H. K Akturk6, G. Todd Alonso6, O. Ebekozien1
Background and Aims: T1D Exchange Quality Improvement Collaborative (T1DX‐QI) is a network of 50 Diabetes clinics across the U.S. sharing data and contributing to QI efforts. In this retrospective, longitudinal analysis, we aimed to examine A1c levels for blood glucometer (BGM) users having switched to continuous glucose monitor (CGM) within a 5‐year follow‐up period.
Methods: We used T1DX‐QI EMR data to identify BGM users within a year of T1D diagnosis and follow them for a 5‐year period to identify switch to CGM. BGM users at baseline are described as T1D patients with first available evidence of BGM use after 1‐year post T1D diagnosis, with an additional record of BGM use from a preceding clinic visit. BGM users who switch to CGM are described as BGM users at baseline who switched to CGM use at any of their subsequent clinic visits within the 5‐year period. Change in A1c was examined across both groups before and after device switch. Change in A1c was also examined for people using CGM at baseline and having switched to BGM use.
Results: Of 18,169 BGM users, 7,709 switched to CGM use. Mean(SD) duration between switch from BGM to CGM was 0.9yrs (1.2). Those who switched from BGM to CGM mean(SD) A1c at baseline was 8.6 (2.1) and after switch to CGM was 8.0 (1.7) [p < 0.001]. For those who switched from CGM to BGM, A1c at baseline and after switch to BGM was 8.2 (2.1) and 8.4(1.9), respectively [p < 0.001].
Conclusions: In this population‐level analysis of real‐world data, CGM initiation was associated with lower A1c, whereas CGM discontinuation was associated with increased A1c.
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