CGM Initiation Soon After Type 1 Diabetes Diagnosis Results in Sustained CGM Use and Wear Time.

Abstract

The majority of youth with type 1 diabetes are above hemoglobin A1c (HbA1c) targets. Continuous glucose monitoring (CGM) has been shown to improve clinical outcomes, and use early in the course of diabetes has the potential to improve glycemic outcomes and improve quality of life. In our clinic, youth with new-onset type 1 diabetes were offered the opportunity to start on CGM (Dexcom G6) soon after diabetes diagnosis. Ongoing CGM coverage was subsequently applied for through the patient’s insurance. Following CGM initiation, youth had a 1-week follow-up with a nurse practitioner. Per clinic standard of care, youth were seen again at 1 month post-diagnosis and every 3 months thereafter. We prospectively collected data on HbA1c, continued CGM use, days of CGM wear, method of viewing CGM data, time in range (TIR), and time in hypoglycemia. Institutional review board approval was obtained for the prospective data collection. From July 2018 to April 2019, we approached 44 youth with newly diagnosed type 1 diabetes to initiate CGM. Forty-one youth (at onset: mean age 9.7 ± 4.1 years, 56% male, 90% with private insurance, 41% non-Hispanic white, HbA1c 12.2 ± 1.8% [110 mmol/mol]) were started on CGM at a mean of 9.0 ± 8.8 days post–diabetes diagnosis (Table 1). Three adolescent youth declined CGM, stating they did …