227-OR: Increasing Quarterly Use of Intermittent CGM among Individuals with T2D Is Associated with Improved Glycemic Control over a One-Year Time Frame

Abstract

Introduction: Continuous glucose monitoring (CGM) is an important tool for biofeedback in diabetes self-management. Intermittent use CGM for T2D users is one approach to address cost and access limitations, but to date only limited evidence supports intermittent use. The objective of this study was to understand the impact of intermittent use CGM in T2D non-intensive insulin users in a real-world setting. Methods: As part of an ongoing implementation study within the Livongo whole person digital health program, a select population of individuals living with T2D who had not previously used CGM and either used no insulin or basal insulin only were mailed and asked to wear Dexcom G6 CGM sensors for 7-10 days per quarter for 4 consecutive quarters. In this analysis, we examined data from 227 individuals who adhered to wearing CGM for at least 7 days in 2 or more quarters. A multiple linear regression design quantified the impact of the primary variable of interest - the number of quarters with CGM wear (2, 3, or 4) - on changes in glycemic control between the first and latest available sensors, while including additional variables (potential confounds) associated with demographic traits, medication use, and temporal aspects of CGM wear. Results: Glycemic control at baseline varied widely; 54% of individuals had a Time In Range (TIR) less than the target of 70%. Among the full sample (N = 227), each additional quarter of CGM use (beyond 2) resulted in clinically meaningful average improvements (and significant partial correlations, all p < .05) in mean sensor glucose (11.8 mg/dL decrease), TIR (7.7 point increase), Time Above Range (7.9 point decrease), and the Glycemia Risk Index (9.3 point decrease). Conclusion: Type 2 non-intensive insulin users who were adherent to quarterly use of intermittent CGM over one year saw meaningful improvements in glycemic control. Providing access to CGM technology may facilitate improvement in outcomes and disease management. Disclosure R.J.Ellis: Employee; Teladoc Health. T.Kompala: Employee; Teladoc Health, Stock/Shareholder; Teladoc Health. R.J.Brooks: Employee; Teladoc Health, Stock/Shareholder; Dexcom, Inc. J.Hone: Employee; Teladoc Health, UnitedHealth Group. A.Salehi: Employee; Teladoc Health. R.James: Employee; Teladoc Health.