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Lin T, Manfredo JA, Illesca N, Abiola K, Hwang N, Salsberg S, Akhtar Y, Mathioudakis N, Brown EA, Wolf RM. Improving Continuous Glucose Monitoring Uptake in Underserved Youth with Type 1 Diabetes: The IMPACT Study. Diabetes Technol Ther 2023; 25:13-19. [PMID: 36223197 DOI: 10.1089/dia.2022.0347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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: NCT04721145.
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Affiliation(s)
- Tyger Lin
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jacquelyn A Manfredo
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicole Illesca
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kai Abiola
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nearry Hwang
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sandra Salsberg
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yasmin Akhtar
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nestoras Mathioudakis
- Department of Medicine, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth A Brown
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Risa M Wolf
- Department of Pediatrics and Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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