935-P: Racial and Ethnic Disparities in the Application of Continuous Glucose Monitoring in Real-World Clinical Settings

Abstract

Background: The use of continuous glucose monitoring (CGM) has improved glycemic control. Disparity in CGM use has been reported; however, the utilization of CGM across a health system in real-world clinical settings remains unknown. We aimed to characterize patients who use CGM and compare them to patients with diabetes who do not use CGM in a large health system. Methods: We retrospectively reviewed the electronic health record (EHR) of patients who received care at NYU Langone Health from 2015. CGM users were those whose EHR records had at least one uploaded CGM report, while CGM non-users were those who had at least one outpatient encounter in which a diabetes diagnosis was documented and who did not have any CGM files uploaded into Epic. Results: We identified 10,515 CGM users and 108,395 CGM non-users. CGM use significantly increased in patients with type 2 diabetes (T2D) after 2019, with higher use of CGM in patients with T2D than those with type 1 diabetes (T1D) (63.6% vs. 36.4%; p<.001). The rate of CGM use was significantly different across racial/ethnic groups: 9.9% of Whites, 7.8% Hispanics/Latinos, 7.5% African Americans, 7.2% Asian, and 7.1% Native Americans. When comparing CGM user among racial groups, CGM user was higher (than non-use) among Whites (60.4% vs 53.1%) and Filipinos (0.68% vs 0.55%), but less frequent among African Americans (13.0% vs 15.6%), Chinese (0.71% vs 1.7%), and Koreans (0.19% vs 0.45%) (p<.001). Regarding the ethnicity, more CGM users were Salvadoran (0.83% vs 0.45%), while less were Puerto Rican (3.3% vs 3.6%), Dominican (1.2% vs 1.4%), and Mexican (0.55 vs 1.4) (p<.001). Conclusions: Using a large real-world clinical setting dataset, our study identified disparity in the CGM use in patients with T1D compared to T2D. Further we noted racial/ethnic disparities in the CGM use and heterogeneity within Hispanics and Asian Americans. Researchers and clinicians should consider interventions to reduce disparities in CGM prescription patterns. Disclosure Y.Zheng: None. E.Iturrate: None. B.Wu: None. J.Fletcher: None. G.D.Melkus: None. S.B.Johnson: None. Funding National Institutes of Health (P30DK111022)