Patient Demographics and Clinical Outcomes Among Type 1 Diabetes Patients Using Continuous Glucose Monitors: Data From T1D Exchange Real-World Observational Study

• Published in: Journal of diabetes science and technology Vol. 17; no. 2; pp. 322 - 328
• Main Authors: DeSalvo, Daniel J., Noor, Nudrat, Xie, Cicilyn, Corathers, Sarah D., Majidi, Shideh, McDonough, Ryan J., Polsky, Sarit, Izquierdo, Roberto, Rioles, Nicole, Weinstock, Ruth, Obrynba, Kathryn, Roberts, Alissa, Vendrame, Francesco, Sanchez, Janine, Ebekozien, Osagie
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.03.2023
• Subjects: Aged; Blood Glucose; Blood Glucose Self-Monitoring; Demography; Diabetes Mellitus, Type 1 - drug therapy; Diabetic Ketoacidosis; Humans; Hypoglycemia; Medicare; Original; United States - epidemiology; United States; diabetes mellitus; severe hypoglycemia; diabetic ketoacidosis; continuous glucose monitoring; hemoglobin A1c; Type 1
• ISSN: 1932-2968; 1932-2968; 1932-3107
• DOI: 10.1177/19322968211049783

Background: The benefits of Continuous Glucose Monitoring (CGM) on glycemic management have been demonstrated in numerous studies; however, widespread uptake remians limited. The aim of this study was to provide real-world evidence of patient attributes and clinical outcomes associated with CGM use across clinics in the U.S. based T1D Exchange Quality Improvement (T1DX-QI) Collaborative. Method: We examined electronic Health Record data from eight endocrinology clinics participating in the T1DX-QI Collaborative during the years 2017-2019. Results: Among 11,469 type 1 diabetes patients, 48% were CGM users. CGM use varied by race/ethnicity with Non-Hispanic Whites having higher rates of CGM use (50%) compared to Non-Hispanic Blacks (18%) or Hispanics (38%). Patients with private insurance were more likely to use CGM (57.2%) than those with public insurance (33.3%) including Medicaid or Medicare. CGM users had lower median HbA1c (7.7%) compared to nonusers (8.4%). Rates of diabetic ketoacidosis (DKA) and severe hypoglycemia were significantly higher in nonusers compared to CGM users. Conclusion: In this real-world study of patients in the T1DX-QI Collaborative, CGM users had better glycemic control and lower rates of DKA and severe hypoglycemia (SH) events, compared to nonusers; however, there were significant sociodemographic disparities in CGM use. Quality improvement and advocacy measures to promote widespread and equitable CGM uptake have the potential to improve clinical outcomes.