SAT115 Diabetes In Pregnancy: Evaluating Access And Usage Of Continuous Glucose Monitors (CGM) In A Medicaid Population

Abstract

Abstract Disclosure: P. Chilukuri: None. J. Llanora: None. A. Schadler: None. K. Playforth: None. K. Naseman: None. Objective: Diabetes complicates up to 17% of pregnancies in the United States annually. Self-monitoring of blood glucose for diabetics requires supplies, knowledge, and support. Continuous glucose monitor (CGM) use for self-monitoring improves clinical outcomes and patient satisfaction. Despite identified benefits, patient access to CGM is variable. Identifying barriers to CGM access is important to promote health equity. Our objective was to describe CGM prevalence in a pregnant population with diabetes. Study Design: This was a single-center, retrospective observational cohort study using electronic health record review of pregnant patients with diagnoses of Type 1 Diabetes (T1DM), Type 2 Diabetes (T2DM), or gestational diabetes (GDM). Patients ages 18 to 50 years with state Medicaid insurance, for whom CGM is a covered benefit, were considered if seen in any of our institution’s obstetrics clinics within a one-year period. Type of diabetes, race/ethnicity, primary language, home county, medication use, and CGM orders were abstracted. Pearson’s Chi-square, Fisher’s exact, and independent samples t-tests were used for analysis. Results: Of 297 total patients, 7.7% (n=23) had T1DM, 22.2% (n=66) had T2DM, 68.4% (n=203) had GDM, and 1.7% (n=5) had another type. Overall, 19% (n=55) had reported CGM use. There was no difference in CGM use for non-white vs. white race (p=0.081) and urban vs. rural home county (p=0.138). Significantly less non-English speaking patients (p=0.001), Hispanic patients (p=0.026), Metformin users (p=0.03), and those not taking medications (p< 0.001) used CGM. Significantly more T1DM (p< 0.001), T2DM (p=0.007), and insulin-using patients (p<0.001) were in the CGM group. Conclusion: In patients with insurance coverage of CGM, awareness of actual usage is key. Social factors of ethnicity and primary language and clinical factors of diabetes type and medication use may affect CGM use. Obstetricians should advocate for equal CGM access for high-risk patients to improve patient outcomes and satisfaction. Presentation: Saturday, June 17, 2023