Nudrat Noor, United States of America

T1D Exchange Quality Improvement and Population Health

Presenter of 2 Presentations

 Conference Calendar
ORAL PRESENTATION SESSION

CONTINUOUS GLUCOSE MONITORING AND CLINICAL OUTCOMES AMONG PATIENTS WITH TYPE 1 DIABETES AND COVID-19: A U.S. BASED MULTI-CENTER OBSERVATIONAL STUDY

Date
Wed, 02.06.2021
Session Name
0050 - Oral Presentation 01 (ID 8)
Lecture Time
18:55 - 19:05
Presenter
Authors

Abstract

Background and Aims

Continuous glucose monitoring (CGM) improves glycemic control and reduces complications in patients with type 1 diabetes (T1D). This study examines the frequency of diabetic ketoacidosis (DKA) and hospitalization among patients with T1D and COVID-19 and CGM use.

Methods

This analysis included all patients with T1D who tested positive for COVID-19 (n=241) in the T1D Exchange COVID-19 Registry. Data for the registry was collected using an online survey tool. Healthcare teams from 52 endocrinology clinics across the U.S. completed the survey using electronic medical records between April and September 2020.

Results

Of the 241 patients included in this analysis, 53% were CGM users and 47% were CGM non-users. CGM non-users were more likely to be on public insurance compared to CGM users (68% vs. 34%). HbA1c in the CGM group was lower compared to non-users (Median [IQR],%: 8.1 [2.6] vs 10.0 [3.3] [p<0.001]), and DKA was less frequent for CGM users relative to the non-users (9% vs 36%) [p<0.001]. Further, patients who did not use CGM were more likely to be hospitalized (33% vs 13%) [p<0.001] or need ICU care [30% vs.6%) [p<0.001] than patients who used CGM.cgm_table.png

Conclusions

Patients with T1D infected with COVID-19 who used a CGM device had lower rates of adverse clinical outcomes than patients who did not use CGM.

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ORAL PRESENTATION SESSION

REAL-TIME CONTINUOUS GLUCOSE MONITORING VERSUS SELF MONITORING OF BLOOD GLUCOSE IN TYPE 1 DIABETES: REAL-WORLD DATA FROM A LARGE U.S. MULTI-CENTER STUDY

Date
Wed, 02.06.2021
Session Name
0050 - Oral Presentation 01 (ID 8)
Lecture Time
19:05 - 19:15
Presenter
Authors

Abstract

Background and Aims

The management of type 1 diabetes (T1D) involves strict glucose control to avoid acute complications. The use of real-time continuous glucose monitors (rtCGM) relative to self-monitoring of blood glucose (SMBG) has demonstrated better glycemic control in T1D patients. This study aims to examine the distribution of patient demographics and frequency of clinical outcomes across the rtCGM and SMBG groups.

Methods

The analysis included 14,248 T1D patients in the T1D Exchange Quality Improvement (T1DX-QI) database for whom electronic medical record data was available from eight endocrinology clinics across the U.S. Patients over 2 years with at least one completed clinic encounter between July 2017 – February 2020 were included for analysis.

Results

In this population, 37% (N=5,276) of T1D patients were rtCGM users, whereas 63% (N=8,972) self-monitored blood glucose. Fewer Non-Hispanic Black (2% vs. 11%) and publicly insured patients (8% vs. 16%) used a rtCGM device relative to the SMBG group [p<0.001]. HbA1c levels were higher in the SMBG group compared to those using rtCGM (Mean [SD],%: 8.8 [2.1] vs. 8.1[1.7] [p<0.001]), and events of severe hypoglycemia (8% vs.10%) and diabetic ketoacidosis (2% vs. 7%) were less frequently recorded for rtCGM users relative to the SMBG group [p<0.001].

cgm_smbg_table.png

Conclusions

This study highlights inequities in adoption of rtCGM for glycemic control, while consolidating previous findings demonstrating rtCGM device use being critical in effective management of blood glucose levels.

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