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COMPARATIVE EFFICACY OF ISCGM, RTCGM, AND SMBG AMONG PATIENTS WITH TYPE 1 DIABETES: REAL-WORLD EVIDENCE FROM A MULTI-CENTER STUDY
Abstract
Background and Aims
Background: Management of type 1 diabetes (T1D) involves consistent glucose monitoring to avoid acute complications. The use of real-time continuous glucose monitors (rtCGM) or intermittently scanning CGM (isCGM) relative to self-monitoring of blood glucose (SMBG) via fingerstick has aided in increasing the number of individuals with T1D reaching glycemic targets. This study aims to compare rtCGM, isCGM, and SMBG groups using real-world data from T1D patients in a large U.S.-based multi-center study.
Methods
Methods: Electronic health record data from the T1D Exchange Quality Improvement (T1DX-QI) Collaborative from 2017-2020 from # sites were analyzed. Patients with complete information on HbA1c, CGM status, and other covariates were included in this analysis. In addition, patients were classified as rtCGM, isCGM, or SMBG users based on their most recent clinic visit data.
Results
Results: This analysis included 21,925 people living with T1D, 2-26 years old, of which 61% were rtCGM users, 5% were isCGM users, and 34% self-monitored blood glucose. Patients in the rtCGM and isCGM group were more likely to be privately insured (73% and 90%) and Non-Hispanic White (73% and 83%) compared to the SMBG group (51% and 69%)[p<0.001 for both]. HbA1c levels and DKA events were lowest in the rtCGM group relative to isCGM and SMBG groups (Median A1c % (IQR): 7.9 (2.1) vs. 8.5(2.2) and 8.7 (2.9); p<0.001, and DKA events (%): 2% vs. 4% and 9%; p<0.001).
Conclusions
Conclusion: This real-world cross-sectional study demonstrates potential benefits of rtCGM relative to isCGM and SMBG in achieving better glycemic outcomes among people with T1D.