Continuous Glucose Monitoring (CGM) Adherence in Youth With Type 1 Diabetes: Associations With Biomedical and Psychosocial Variables

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Abstract

Background:

Continuous glucose monitoring (CGM) remains underutilized in youth with type 1 diabetes (T1D). There is a need to investigate factors associated with CGM use.

Method:

In 61 T1D youth, CGM use was ascertained by downloads reflecting the 4-week periods preceding 3- and 6-month study visits. Demographic and clinical data were obtained from chart review and interview. Youth and parents completed validated psychosocial surveys at baseline and 6 months.

Results:

Youth (52% male, 93% Caucasian, 80% pump treated) were 12.7 ± 2.9 years old, with T1D for 6.3 ± 3.8 years; mean A1c was 7.9 ± 0.9%. Mean CGM use was 4.1 ± 2.1 days/week (median = 4.8) at 3 months and 3.4 ± 2.3 days/week (median = 3.9) at 6 months. At 3 and 6 months, 15% and 20% of youth, respectively, had stopped using CGM. At 6 months, youth using CGM 6-7 days/week had more frequent BG monitoring (P = .05), less insulin omission (P = .02), and greater probability of A1c < 7.5% (P = .01) than youth using CGM less often. Youth using CGM 6-7 days/week consistently over the 6 months demonstrated lower A1c at 3 months compared to baseline (P = .03) and the improvement was sustained at 6 months (P = .5, 3 vs 6 months); youth using CGM less often had no significant A1c change. Baseline BG monitoring ≥8 times/day or A1c within target (<7.5%) predicted greater CGM use (6-7 days/week) at 6 months (OR = 4.6, P = .02). There was no deterioration of psychosocial functioning with CGM use.

Conclusions:

Consistent and durable CGM use in youth with T1D is associated with treatment adherence and improved glycemic control without increasing psychosocial distress.

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