Every year the Advanced Technologies & Treatments for Diabetes (ATTD) conference brings together diabetes researchers from all over the world. This year, the conference was held virtually June 2-5, 2021.

We were honored to present several studies at this year’s conference. Check out the summaries below of each study presented by the T1D Exchange team at ATTD!

Real-time Continuous Glucose Monitoring (CGM) Versus Self-Monitoring of Blood Glucose in Type 1 Diabetes (T1D)

For this study, several of the clinics in the T1D Exchange Quality Improvement Collaborative (QIC) worked together to look at the T1D outcomes for two groups: people who use CGMs and people who self-monitor their blood glucose levels.

Of the more than 14,000 people with T1D in this study, 37% were CGM users and 63% were self-monitored.

This study found that the self-monitored group had a higher average A1c level at 8.8% compared to the group of CGM users, which had an average A1c of 8.1%. Additionally, the group of CGM users had fewer severe hypoglycemia events than the self-monitored group, and fewer instances of diabetes-related ketoacidosis (DKA).

The study also highlighted that fewer non-Hispanic Black and publicly insured people with T1D used a CGM relative to the self-monitored group. These inequities in CGM adoption are consistent with other T1D Exchange study findings and reinforce our work to build the T1D Health Equity Framework.

Full study abstract listed under number O043 at this link: https://www.liebertpub.com/doi/10.1089/dia.2021.2525.abstracts

CGM Usage and Health Outcomes among People with T1D and COVID-19

As part of the T1D Exchange COVID-19 Surveillance Study, we wanted to examine CGM usage among people with T1D and COVID-19 who experienced hospitalization and/or DKA.

Of the 241 people with T1D and COVID-19 included in this analysis, 53% were CGM users and 47% were CGM non-users. Average A1c levels were lower in the CGM users at 8.1% compared to the CGM non-users at 10.0%.

Through this study, we found that people with T1D who did not use a CGM were more likely to be hospitalized with COVID-19, with 33% of CGM non-users requiring hospitalization. By contrast, the CGM user group had a hospitalization rate of 13%.

This study also found that CGM users with COVID-19 saw fewer instances of DKA compared to CGM non-users. Of CGM users, 9% experienced DKA, compared to 36% of CGM non-users.

Overall, people with T1D and COVID-19 who used a CGM had lower rates of adverse clinical outcomes than patients who did not use a CGM. This study reiterates how vital it is that all people with T1D can access and afford a CGM, especially in the midst of a pandemic.

Full study abstract listed under number O042 at this link: https://www.liebertpub.com/doi/10.1089/dia.2021.2525.abstracts

Health Outcomes in COVID-19 Positive Patients with T1D Using an Insulin Pump

Similar to the previous study, we wanted to assess insulin pump usage among people with T1D and COVID-19 who experienced hospitalization and/or DKA.

In the T1D Exchange COVID-19 Surveillance Study, 38% of people with T1D and COVID-19 were insulin pump users and 62% were insulin pump non-users. Average A1c levels were lower among the insulin pump user group at 8.0% compared to the non-user group at 9.8%.

Adverse events such as DKA and hospitalization were less frequently recorded for insulin pump users relative to non-users. Of insulin pump users, 9% experienced DKA, compared to 30% of insulin pump non-users.

Further, people with T1D and COVID-19 who did not use an insulin pump were more likely to be hospitalized. While 29% of insulin pump non-users required hospitalization, the insulin pump user group had a hospitalization rate of 12%.

People with T1D and COVID-19 who used insulin pump therapy had lower rates of adverse outcomes. This study adds to the literature showing the importance of T1D tech access and affordability for everyone with T1D, particularly through a global health crisis.

Full study abstract listed under number O078 at this link: https://www.liebertpub.com/doi/10.1089/dia.2021.2525.abstracts

Challenges of Transitioning to Telehealth During COVID-19

When the COVID-19 pandemic escalated in the U.S. last year, appointments for diabetes clinic visits rapidly switched from in-person to virtual. Every aspect of providing T1D care was impacted in some way by this shift, including the way data is shared with health care providers, technological capabilities, billing processes and more.

To understand this shift, we surveyed clinics in the T1D Exchange QIC about access to technology tools, the telehealth visit process and insurance coverage.

Out of 21 clinics (16 pediatric and 5 adult), 62% used both video software and phone calls. Similarly, 62% of clinics created workflows to get their patients’ lab results. 62% of the clinics also reported that they were prescribing CGMs and pumps virtually. The clinics reported that insurance covered 95% of virtual visits.

38% of clinics surveyed had a process for screening their patients for depression, however only 3 clinics had psychologists available for virtual appointments.

This study gives a spotlight to the remarkable speed with which diabetes clinics and health care providers adapted to telehealth during a global pandemic. Future studies will assess the effectiveness of virtual visits in different groups within the T1D community.

Read the Full Study: Adoption of Telemedicine for Type 1 Diabetes Care During the COVID-19 Pandemic