SAN DIEGO According to a speaker, children with type 1 diabetes who started using continuous glucose monitors (CGMs) within six months of diagnosis had a lower HbA1c at three years than those who started CGM six to twelve months later.
At the American Diabetes Association Scientific Sessions, Elizabeth A. Mann, MD, an assistant professor of pediatric endocrinology and diabetes at the University of Wisconsin-Madison, stated, “This multi-institution analysis of more than 10,000 people with type 1 [diabetes] shows long-term HbA1c improvement for individuals able to initiate CGM within 6 months of diagnosis.” “In this group, the timing of Continuous Glucose Monitors commencement was unaffected by age, gender, or insurance type. According to these clinical data, non-Hispanic Black adolescents have a lower likelihood of having access to technology.
CGM Uptake Among Youth
This is in line with epidemiological studies that indicate minority communities adopt diabetic technologies at a lower rate. Researchers examined data from type 1 diabetic children and adolescents (17 years of age and younger) who attended clinics included in the T1D Exchange Quality Improvement Collaborative and reported using CGM between 2017 and 2022. It was determined that 2,306 participants had started CGM within 3 months of diagnosis, 1,440 participants did so between 3 and 6 months of diagnosis, 1,593 participants did so between 6 and 12 months of diagnosis, and 5,500 participants did not use Continuous Glucose Monitors. Three years after the diagnosis, the HbA1c was obtained.
Early CGM Benefits on HbA1c
When compared to children who started CGM between three and six months after diagnosis, who started CGM between six and twelve months after diagnosis, and non-users, who started CGM between three and six months after diagnosis, the HbA1c of children who started Continuous Glucose Monitors within three months of diagnosis was 7.3% on average over three years (P <.001).
All groups’ HbA1c trajectories rose throughout the investigation. At 12 and 18 months, those who started CGM six to twelve months after diagnosis had greater HbA1cs than the other CGM groups; however, according to Mann, the difference in HbA1c between the three CGM groups narrowed at 24, 30, and 36 months.
CGM Disparities Among Youth
Of the non-Hispanic Black kids who took part in the research, 25% said they used a CGM and 75% said they did not (P <.00025). There were no discernible variations in the utilization of CGM between white non-Hispanic children and Hispanic youngsters.
Mann talked about some strategies the medical community may employ to help children with type 1 diabetes start using Continuous Glucose Monitors (CGMs) earlier and to lessen the differences in how they use diabetes technology.
Improving Continuous Glucose Monitors Access Equity
According to Mann, “future efforts need to focus on system improvements that support early access to CGM in addition to Continuous Glucose Monitors use.” “[Quality improvement] efforts need to focus on disadvantaged or marginalized populations that have lower uptake to reduce disparities, rather than interventions that improve access universally, which may unintentionally increase disparities despite improving overall access.”
According to Mann, reducing CGM discrepancies requires addressing implicit provider prejudice.
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FAQs
What was the main topic of Elizabeth A. Mann, MD’s research presentation addressing children with type 1 diabetes and continuous glucose monitoring (CGM)?
The study concentrated on the effects of early versus delayed CGM start on the results of long-term glucose management in kids with type 1 diabetes.
What were the key conclusions on the timing of CGM initiation and HbA1c levels?
When comparing the median HbA1c levels over 3 years, children who began using CGM within 6 months after receiving a type 1 diabetes diagnosis had lower levels than those who either started using CGM between 6 and 12 months after diagnosis or did not use it at all.
What long-term effects did the date of CGM commencement have on HbA1c trajectories?
HbA1c trajectories for kids beginning CGM between 6 and 24 months old initially revealed higher levels. For children who began CGM between 6 and 12 months following diagnosis, HbA1c trajectories initially revealed higher values; however, over three years, the discrepancies between Continuous Glucose Monitors groups were reduced.
What differences in CGM use did the study find between the various racial groups?
In contrast to non-Hispanic White and Hispanic children, 75% of non-Hispanic Black children did not use CGM, according to the study, revealing differences in technology access.
How may we improve early access for kids with type 1 diabetes and address discrepancies in CGM use, according to Elizabeth A. Mann?
To assist early CGM initiation and remove implicit provider biases that contribute to disparities in diabetes technology utilization across minority populations, Dr. Mann stressed the need for reforms to the healthcare system.
Which particular participant groups were included in the study according to the timing of CGM initiation?
The participants were divided into groups according to when they started using continuous glucose monitoring (CGM) following their diagnosis of type 1 diabetes: within 3 months, 3 to 6 months, 6 to 12 months, or as non-users.
In what ways did the study take age, gender, and type of insurance into consideration when determining when to start CGM?
The research highlighted the wide applicability of the findings across a variety of patient populations by revealing that the timing of Continuous Glucose Monitors beginning was irrespective of demographic parameters including age, gender, or insurance type.
In comparison to other racial groups, what were the statistical results regarding the use of CGM among non-Hispanic Black children?
Comparing non-Hispanic White and Hispanic children with non-Hispanic Black children, who exhibited no significant differences in CGM usage rates, statistical analysis indicated considerable inequalities, with 75% of the former group not using CGM.
What effects might the study’s conclusions have on enhancing clinical practice’s diabetes management techniques?
The results highlighted the value of early Continuous Glucose Monitors availability in enhancing children with type 1 diabetes’s long-term glycemic control outcomes and offered suggestions for future improvements to clinical guidelines and patient management techniques.
What suggestions did Elizabeth A. Mann make to alleviate the discrepancies in minority communities’ adoption of CGM?
Dr. Mann promoted targeted quality improvement initiatives aimed at lowering obstacles to CGM access for underprivileged or marginalized groups, to minimize inequalities in diabetes technology and care.
Principal conclusions
- Compared to initiating CGM later, early adoption of continuous glucose monitoring (CGM) within 6 months of the diagnosis of type 1 diabetes resulted in decreased HbA1c levels at 3 years.
- 75% of non-Hispanic Black children do not use CGM, a notable difference that underscores unequal access to diabetes technology.
