358-OR: Better Adherence to Real-Time Continuous Glucose Monitoring (rtCGM) than to Intermittently Scanned CGM (isCGM) among People with Type 2 Diabetes (PWT2D) on Intensive Insulin Therapy (IIT)

Abstract

Background: For PWT2D, medication regimen adherence is associated with improved glycemic control and reduced health care utilization. However, little is known about CGM adherence for managing T2D, and how it varies by type of CGM. Materials and Methods: A retrospective analysis of Merative’s MarketScan® US healthcare claims data was conducted. The cohort included CGM-naïve PWT2D on IIT who initiated rtCGM or isCGM between 1/1/2017 through 12/31/2020 (index date=earliest observed pharmacy claim). Adherence was defined as having ≥80% proportion of days covered (PDC) by pharmacy claims. Inclusion criteria were adults ≥30 years of age with T2D, using bolus insulin, with continuous health plan enrollment coverage 12 months before (baseline) and 12 months after the index date (follow-up), and no evidence of prior CGM use. The association between CGM adherence and change in A1C was examined in a subset of 663 patients with 6-month baseline and 6-month follow-up laboratory values. Results: The rtCGM group (n=2,349) was [mean (SD)] 49.2 (8.0) years of age and 48% female, while the isCGM group (n=8,881) was 50.4 (8.0) years of age and 48% female. Average PDC was 85% (26%) for the rtCGM group and 68% (32%) for the isCGM group. A total of 76.2% of the rtCGM group and 50.6% of the isCGM group met the ≥80% PDC level of adherence. A multivariate logistic regression model showed the odds of adherence were three times greater for rtCGM compared to isCGM (OR=3.2, 95% CI 2.8-3.5, p<0.001). Those adherent to CGM, regardless of device type, had a greater decrease in A1C (-0.94%) compared to those who did not meet the adherence criterion (-0.54%) (p<0.001). Conclusions: These findings indicate that for PWT2D on IIT, adherence to rtCGM is higher than to isCGM. The association between adherence and reduced A1C suggests patients can improve glycemic control with consistent use of CGM. Disclosure P.Nemlekar: Employee; Dexcom, Inc. K.Hannah: Employee; Dexcom, Inc. G.J.Norman: Employee; Dexcom, Inc. Funding Dexcom, Inc.