Improving Continuous Glucose Monitoring Uptake in Underserved Youth with Type 1 Diabetes: The IMPACT Study

Tyger Lin, Jacquelyn A. Manfredo, Nicole Illesca, Kai Abiola, Nearry Hwang, Sandra Salsberg, Yasmin Akhtar, Nestoras Mathioudakis, Elizabeth A. Brown, Risa M. Wolf

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Continuous glucose monitoring (CGM) improves glycemic control. Less than half of youth with type 1 diabetes (T1D) use CGM, with disparities among minority and low-income youth. The aim of this study was to determine if trial CGM use increases uptake of personal CGM. Methods: T1D youth were provided sample CGM placement at the point of care, with CGM education and app setup. Follow-up calls at 5 and 10 days assessed CGM data, and desire to continue using CGM. Follow-up at 3-6 months recorded CGM use, CGM data, and A1c. Participants completed surveys at enrollment, 10 days, and 3 months. Differences were assessed between baseline and follow-up. Results: Of the 26 enrolled participants with T1D, 15 were CGM naive, and 11 were prior CGM users. The mean age was 14.1 ± 2.9 years, 65% male, 42% were Black, 12% were Hispanic, 65% were on public insurance, and 43% had household income of <$50,000. The median duration of diabetes was 4.6 years (interquartile range 2.4-7.7), mean baseline A1c was 10.7% ± 2.4%. After trial CGM use, 85% of participants reported wanting personal CGM, and at 3-6 months follow-up 76% had obtained one and 43% were using a personal CGM. There were no improvements in A1C or time in range, but participants reported an increase in the perceived benefits of CGM usage (4.0 vs. 4.3, p = 0.03). Conclusions: Placing a sample CGM at the point of care can improve uptake of personal CGM and may help mitigate disparities in CGM use in minority and underserved youth. Long-term studies are needed to determine how similar interventions impact glycemic control and patient outcomes. ClinicalTrials.gov:

Original languageEnglish (US)
Pages (from-to)13-19
Number of pages7
JournalDiabetes Technology and Therapeutics
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2023

Keywords

  • Barriers
  • Continuous glucose monitors
  • Glycemic control
  • Type 1 diabetes

ASJC Scopus subject areas

  • Medical Laboratory Technology
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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