1002-P: Implementing Continuous Glucose Monitoring in Children with Type 2 Diabetes

Abstract

Background: Continuous glucose monitor (CGM) is a widely accepted tool for managing glycemia in youth with type 1 diabetes (T1D) and adults with type 2 diabetes (T2D) ; however, studies exploring its use in T2D in youth are limited. Objective: Determine if a day trial use of CGM in youth with T2D improves short term and long term glycemic control as measured by time in range (TIR = percentage of time blood glucose is 70-180 mg/dL) , and 3 mo hemoglobin A1c (HbA1c) , respectively. Methods: Youth with T2D for more than 3 mos, on insulin therapy, with no prior CGM use were enrolled. Diabetes staff placed the CGM at the point of care and provided standardized education. At initial visit, HbA1c and demographic information were recorded. Participants received a 5 day and day follow up (FU) phone call from diabetes staff to review glucose and TIR data, with counseling and dose adjustments as needed. At 3 mos, HbA1c was recorded. We compared 5 day TIR and day TIR, and baseline and 3 mo HbA1c via paired t-test. Results: Youth with T2D (n=35) enrolled had mean age of 15.9 y (SD 1.9 y) , 63% female, 83% black, and average diabetes duration of 1.8 y (SD 1.6 y) . A majority had household income <$50K (63%) and parental education level of HS degree or less (68%) . Average 5 day TIR 48% was similar to day TIR 51% (p=0.28) . There was no change in HbA1c after 3 months (10.3% v 11.1%, p=0.39) . Only 18 participants completed the full day CGM use; those that did not cited device connection issues (3) , device fell off early (8) , device removed early due to irritation (3) or lost to FU (3) . Of the 18 youth who completed day CGM use and nursing FU calls, 78% wanted to use a CGM long term. Conclusion: Although a trial CGM use over days did not impact short term or long term glycemic control in youth with T2D, most participants who completed the full days wanted to continue using CGM. Issues with device connectivity and adhesion were barriers to consistent device use. Future larger studies with longer use of CGM may help clarify the potential impact of CGM in youth with T2D. Disclosure J.A.Manfredo: None. R.M.Wolf: Consultant; NEMA Research, Research Support; Dexcom, Inc. T.L.Lin: None. R.Gupta: Consultant; Cabaletta Bio. K.Abiola: None. M.West: None. K.Busin: None. J.Tracey: None. E.A.Brown: None. S.N.Magge: None. Funding Johns Hopkins Childrens Center Innovation Award Dexcom (investigator-initiated support)