955-P: Evaluating Early Initiation of Continuous Glucose Monitoring (CGM) among Youth Diagnosed with Type 1 Diabetes (T1D)

Abstract

Background: CGM has glycemic and psychosocial benefits. The current study sought to evaluate the specific impact of introducing CGM soon after diagnosis of T1D. Methods: A sample of 55 youth recently diagnosed with T1D were randomized to either an intervention (start Dexcom G5 CGM within 1 month of diagnosis) or control (monthly blinded CGM use) condition. HbA1c data and youth and parent surveys were collected at baseline, 13 and 26 weeks and glucose levels were measured via blinded or unblinded CGM. T-tests were used to compare groups based on glycemic and psychosocial outcomes. Results: Participant ages ranged from 3-18 (mean 11.1 ± 3.6years). On average, youth in the intervention group spent less time in hypoglycemia at 13 (2.0% vs. 7.5%, p=0.002) and 26 (1.9% vs. 4.9%, p=0.056) weeks and had elevated scores on the Diabetes Self Management Profile at week 13 (54.5 vs. 43.9 p=0.021) and more openness with glucose monitoring at weeks 13 (15.0 vs. 12.2, p=0.057) and 26 (16.42 vs. 12.12, p=0.014). Conversely, intervention group youth reported worse quality of life (QoL) at 13 weeks (8.5 vs. 3.0, p=0.020). At 26 weeks, the intervention group had slightly higher diabetes distress among youth (32.2 vs. 25.4, p=0.089) but lower diabetes distress among parents (42.5 vs. 50.9, p=0.050). Adding to prior reports from this study, these results show reduced hypoglycemia, improved attitudes toward diabetes technology, and satisfaction with glucose monitoring as well as decreased parent reported youth QoL. Conclusion: Introducing CGM soon after diagnosis appears to have substantial benefits, including prevention of hypoglycemia and bolstering youth self-management practices and openness to glucose monitoring. Given that early CGM initiation may negatively impact QoL in youth with T1D, as indicated by both youth and parent report, youth with T1D may benefit from education around use of CGM as well as psychosocial support for those with lower QoL. Disclosure J.J. Wong: None. S. Clay: None. G.P. Forlenza: Advisory Panel; Self; Dexcom, Inc. Consultant; Self; Medtronic MiniMed, Inc., Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. S. Hanes: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Beta Bionics, MannKind Corporation, Novo Nordisk Inc., Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Other Relationship; Self; Dexcom, Inc. K.K. Hood: Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc. Speaker's Bureau; Self; Johnson & Johnson Diabetes Institute. Funding Dexcom, Inc.