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Clinical Care/Education/Nutrition/Psychosocial Research

Real-Time Continuous Glucose Monitoring Among Participants in the T1D Exchange Clinic Registry

  1. Jenise C. Wong1,
  2. Nicole C. Foster2,
  3. David M. Maahs3,
  4. Dan Raghinaru2,
  5. Richard M. Bergenstal4,
  6. Andrew J. Ahmann5,
  7. Anne L. Peters6,
  8. Bruce W. Bode7,
  9. Grazia Aleppo8,
  10. Irl B. Hirsch9,
  11. Lora Kleis10,
  12. H. Peter Chase3,
  13. Stephanie N. DuBose2,
  14. Kellee M. Miller2⇑,
  15. Roy W. Beck2 and
  16. Saleh Adi1
  17. for the T1D Exchange Clinic Network*
  1. 1Madison Clinic for Pediatric Diabetes and University of California San Francisco, San Francisco, CA
  2. 2Jaeb Center for Health Research, Tampa, FL
  3. 3Barbara Davis Center for Childhood Diabetes, Aurora, CO
  4. 4International Diabetes Center Park Nicollet, Minneapolis, MN
  5. 5Harold Schnitzer Diabetes Health Center at Oregon Health and Science University, Portland, OR
  6. 6Keck School of Medicine of the University of Southern California, Los Angeles, CA
  7. 7Atlanta Diabetes Associates, Atlanta, GA
  8. 8Northwestern University, Chicago, IL
  9. 9University of Washington, Seattle, WA
  10. 10Helen DeVos Children’s Hospital, Grand Rapids, MI
  1. Corresponding author: Kellee M. Miller, t1dstats{at}jaeb.org.
Diabetes Care 2014 Oct; 37(10): 2702-2709. https://doi.org/10.2337/dc14-0303
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Abstract

OBJECTIVE To assess the frequency of continuous glucose monitoring (CGM) device use, factors associated with its use, and the relationship of CGM with diabetes outcomes (HbA1c, severe hypoglycemia [SH], and diabetic ketoacidosis [DKA]).

RESEARCH DESIGN AND METHODS Survey questions related to CGM device use 1 year after enrollment in the T1D Exchange clinic registry were completed by 17,317 participants. Participants were defined as CGM users if they indicated using real-time CGM during the prior 30 days.

RESULTS Nine percent of participants used CGM (6% of children <13 years old, 4% of adolescents 13 to <18 years, 6% of young adults 18 to <26 years, and 21% of adults ≥26 years). CGM use was more likely with higher education, higher household income, private health insurance, longer duration of diabetes, and use of insulin pump (P < 0.01 all factors). CGM use was associated with lower HbA1c in children (8.3% vs. 8.6%, P < 0.001) and adults (7.7% vs. 7.9%, P < 0.001). In adults, more frequent use of CGM (≥6 days/week) was associated with lower mean HbA1c. Only 27% of users downloaded data from their device at least once per month, and ≤15% of users reported downloading their device at least weekly. Among participants who used CGM at baseline, 41% had discontinued within 1 year.

CONCLUSIONS CGM use is uncommon but associated with lower HbA1c in some age-groups, especially when used more frequently. Factors associated with discontinuation and infrequent use of retrospective analysis of CGM data should be considered in developing next-generation devices and education on CGM use.

Footnotes

  • This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc14-0303/-/DC1.

  • ↵* A complete list of members of the T1D Exchange Clinic Network can be found in the Supplementary Data.

  • Received January 31, 2014.
  • Accepted June 14, 2014.
  • © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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Diabetes Care: 37 (10)

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October 2014, 37(10)
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Real-Time Continuous Glucose Monitoring Among Participants in the T1D Exchange Clinic Registry
Jenise C. Wong, Nicole C. Foster, David M. Maahs, Dan Raghinaru, Richard M. Bergenstal, Andrew J. Ahmann, Anne L. Peters, Bruce W. Bode, Grazia Aleppo, Irl B. Hirsch, Lora Kleis, H. Peter Chase, Stephanie N. DuBose, Kellee M. Miller, Roy W. Beck, Saleh Adi
Diabetes Care Oct 2014, 37 (10) 2702-2709; DOI: 10.2337/dc14-0303

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Real-Time Continuous Glucose Monitoring Among Participants in the T1D Exchange Clinic Registry
Jenise C. Wong, Nicole C. Foster, David M. Maahs, Dan Raghinaru, Richard M. Bergenstal, Andrew J. Ahmann, Anne L. Peters, Bruce W. Bode, Grazia Aleppo, Irl B. Hirsch, Lora Kleis, H. Peter Chase, Stephanie N. DuBose, Kellee M. Miller, Roy W. Beck, Saleh Adi
Diabetes Care Oct 2014, 37 (10) 2702-2709; DOI: 10.2337/dc14-0303
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