ESPE Abstracts (2018) 89 P-P1-072

Increasing Use of Continuous Glucose Monitoring (CGM) Among Youth with Type 1 Diabetes (T1D): Icomparison of Youth from the T1D Exchange (T1DX) and the DPV Initiative

Kellee Millera, Julia Hermannb,c, David Maahsd, Sabine Hofere, Nicole Fostera & Reinhard Hollb,c

aJaeb Center for Health Rresearch, Tampa, USA; bUniversity of Ulm, ZIBMT, Institute of Epidemiology and Medical Biometry; German Center for Diabetes Research, Ulm, Germany; cGerman Center for Diabetes Research (DZD), Munchen-Neuherberg, Germany; dStanford University School of Medinice, Stanford, USA; eMedical University of Innsbruck, Department of Pediatrics, Innsbruck, Austria

Objectives: To assess change in rates of pediatric CGM use over the past 5 years across demographic and clinical characteristics and association with hemoglobin A1c (HbA1c), data from 2 registries were compared: the US-based T1DX and the German/Austrian DPV.

Methods: Registry participants in DPV and T1DX aged <18yrs with T1D duration ≥ 1yr with available data in any of the following years were included in the analysis (N for each year by registry shown in the Table). Demographic data, CGM use, insulin delivery method HbA1c were obtained from medical records.

Results: CGM use increased from 2011 to 2017 in all age groups in both registries, and was most pronounced in the youngest patients (Table 1). In the DPV registry, CGM use remained steady from 2011 to 2015 with a dramatic increase from 4% to 44% occurring between years 2015 and 2017, whereas for T1DX, CGM use doubled from 4% in 2013 to 14% in 2015 to 31% in 2017. CGM use in both registries increased from 2011 to 2017 regardless of gender or minority status. Among DPV participants using injections for insulin delivery CGM use increased from 3% to 35% compared with 5% to 50% among pump users. Among T1DX participants CGM use increased from 1% to 13% among injection users and 5% to 40% among pump users. Average age, gender and minority status adjusted HbA1c in 2017 was lower in CGM users than non-users for both registries (T1DX 8.2%/66 mmol/mol vs. 9.2%/78 mmol/mol; DPV 7.7%/61 mmol/mol vs. 8.0%/64 mmol/mol, P<0.001 for both)

Table 1
2011 N=176322013 N=194842015 N=208582017 N=217072011 N=90602013 N=83342015 N=90892017 N=9184
% CGM Use Overall4%3%4%44%3%4%14%31%
% CGM Use by Age group
1-<6 yrs6%6%10%57%5%7%32%52%
6-<13 yrs3%3%5%49%3%4%18%37%
13-<18 yrs4%2%3%38%3%3%11%25%

Conclusions: Pediatric CGM use increased in both registries but at different rates from 2011 to 2017. Increase in CGM use over time is likely reflective of changes in insurance coverage and improvements in device technology and availability. Although current CGM users had significantly lower HbA1c than non-users, whether increase in CGM use leads to improvements in glycemic control and reduction in acute complications warrants exploration.

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