Patient Demographics and Clinical Outcomes Among Type 1 Diabetes Patients Using Continuous Glucose Monitors: Data From T1D Exchange Real-World Observational Study
Open accessAbstract
Background: The benefits of Continuous Glucose Monitoring (CGM) on glycemic management have been demonstrated in numerous studies; however, widespread uptake remians limited. The aim of this study was to provide real-world evidence of patient attributes and clinical outcomes associated with CGM use across clinics in the U.S. based T1D Exchange Quality Improvement (T1DX-QI) Collaborative. Method: We examined electronic Health Record data from eight endocrinology clinics participating in the T1DX-QI Collaborative during the years 2017-2019. Results: Among 11,469 type 1 diabetes patients, 48% were CGM users. CGM use varied by race/ethnicity with Non-Hispanic Whites having higher rates of CGM use (50%) compared to Non-Hispanic Blacks (18%) or Hispanics (38%). Patients with private insurance were more likely to use CGM (57.2%) than those with public insurance (33.3%) including Medicaid or Medicare. CGM users had lower median HbA1c (7.7%) compared to nonusers (8.4%). Rates of diabetic ketoacidosis (DKA) and severe hypoglycemia were significantly higher in nonusers compared to CGM users. Conclusion: In this real-world study of patients in the T1DX-QI Collaborative, CGM users had better glycemic control and lower rates of DKA and severe hypoglycemia (SH) events, compared to nonusers; however, there were significant sociodemographic disparities in CGM use. Quality improvement and advocacy measures to promote widespread and equitable CGM uptake have the potential to improve clinical outcomes.
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Prior studies demonstrate prominent socioeconomic disparities in insulin pump use in regions without public funding, such as Brazil and the United States.
“Our findings of greater disparities in insulin pump use are consistent with prior studies demonstrating prominent socioeconomic disparities in regions without public funding, such as Brazil and the United States.”
From Social disadvantage and technology use among adults with type 1 diabetes in Quebec: A cross‐sectional study using data from the Canadian <scp>T1D</scp> ( <scp>BETTER</scp> ) Registry (2025) · cites this paper as [37]
The Discussion (page not provided) says socioeconomic status and insurance coverage can affect insulin pump and CGM use because of financial constraints. However, this study measures CGM use in U.S. clinics, not insulin pump disparities; it does not address Brazil or establish that either region lacks public funding. (LLM, conf=0.86)
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Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., Maahs, D. M., & Tamborlane, W. V. (2015) · Diabetes Care · doi:10.2337/dc15-0078 · Cited by 1,254 · see citing works
Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., Kollman, C., Kruger, D., McGill, J. B., Polonsky, W., et al. (2017) · JAMA · doi:10.1001/jama.2016.19975 · Cited by 1,185 · see citing works
Racial-ethnic disparities in management and outcomes among children with type 1 diabetes
Willi, S. M., Miller, K. M., DiMeglio, L. A., Klingensmith, G. J., Simmons, J. H., Tamborlane, W. V., Nadeau, K. J., Kittelsrud, J. M., Huckfeldt, P., Beck, R. W., et al. (2015) · Pediatrics · doi:10.1542/peds.2014-1774 · Cited by 367 · see citing works
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Research works printed but not linked: 15
- Foster NC, Beck RW, Miller KM, et al. State of type 1 diabetes management and outcomes from the T1D exchange in 2016- 2018. Diabetes Technol Ther. 2019;21(2):66-72.
- Laffel LM, Kanapka LG, Beck RW, et al. Effect of continu- ous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. JAMA. 2020;323(23):2388-2396.
- Lind M, Polonsky W, Hirsch IB, et al. Continuous glucose moni- toring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. JAMA. 2017;317(4):379-387.
- Alonso GT, Corathers S, Shah A, et al. Establishment of the T1D Exchange Quality Improvement Collaborative (T1DX-QI). Clinical Diabetes. 2020;38(2):141-151.
- Paris CA, Imperatore G, Klingensmith G, et al. Predictors of insulin regimens and impact on outcomes in youth with type 1 diabetes: the SEARCH for diabetes in youth study. J Pediatr. 2009;155(2):183-189e1.
- Valenzuela JM, La Greca AM, Hsin O, Taylor C, Delamater AM. Prescribed regimen intensity in diverse youth with type 1 diabetes: role of family and provider perceptions. Pediatr Diabetes. 2011;12(8):696-703.
- Commissariat PV, Boyle CT, Miller KM, et al. Insulin pump use in young children with type 1 diabetes: sociodemographic factors and parent-reported barriers. Diabetes Technol Ther. 2017;19(6):363-369.
- Lawrence JM, Divers J, Isom S, et al. Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017. JAMA. 2021;326(8):717-727.
- Wang L, Li X, Wang Z, et al. Trends in Prevalence of diabetes and control of risk factors in diabetes among US adults, 1999-2018. JAMA. 2021;326(8):704-716. doi:10.1001/jama.2021.9883. · DOI
- Ebekozien O, Agarwal S, Noor N, et al. Inequities in diabetic ketoacidosis among patients with type 1 diabetes and COVID- 19: data from 52 U.S. Clinical Centers. J Clin Endocrinol Metab. http://doi.org/10.1210/clinem/dgaa920. · DOI
- Noor N, Ebekozien O, Levin L., et al. Diabetes technology use for management of type 1 diabetes is associated with fewer adverse COVID19 outcomes: findings from the T1D exchange COVID-19 surveillance registry. Diabetes Care. 2021;44:e160-e162.
- Corathers SD, Schoettker PJ, Clements MA, et al. Health- system-based interventions to improve care in pediatric and adolescent type 1 diabetes. Curr Diab Rep. 2015;15(11):91.
- Ginnard OZB, Alonso GT, Corathers SD, et al. Quality improve- ment in diabetes care: a review of initiatives and outcomes in the T1D Exchange Quality Improvement Collaborative. Clin Diabetes. 2021;39:256-263.
- Prahalad P, Ebekozien O, Alonso GT, et al. Multi-clinic quality improvement initiative increases continuous glucose monitor- ing use among adolescents and young adults with type 1 diabe- tes. Clin Diabetes. 2021;39:264-271.
- Ebekozien O, Odugbesan O, Rioles N, et al. Equitable post- COVID-19 care: a practical framework to integrate health equity in diabetes management. Journal of Clinical Outcomes Management. 2020;27(6):256-259.
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Self-citation
- Authors
- DeSalvo, D. J., Noor, N., Xie, C., Corathers, S. D., Majidi, S., McDonough, R. J., Polsky, S., Izquierdo, R., Rioles, N., Weinstock, R., Obrynba, K., Roberts, A., Vendrame, F., Sanchez, J., & Ebekozien, O.
- Affiliations
- Baylor College of Medicine (US)
- T1D Exchange (US)
- Texas Tech University Health Sciences Center (US)
- Cincinnati Children's Hospital Medical Center (US)
- Barbara Davis Center for Diabetes, Aurora, CO, USA
- Children's Mercy Hospital (US)
- SUNY Upstate Medical University (US)
- Nationwide Children's Hospital (US)
- Seattle Children's Hospital (US)
- University of Miami (US)
- University of Mississippi (US)
- ORCID
- Venue
- Journal of Diabetes Science and Technology
- Publisher
- SAGE Publications
- Published
- 2021-10-09
- Volume
- 17
- Issue
- 2
- Pages
- 322-328
- ISSN
- 1932-2968 (ISSN-L)
- PMC
- PMC10012384
- OpenAlex
- W3207603420
- Cited by
- 113
- References
- 3
- Citations by year
- 2026: 7 · 2025: 37 · 2024: 22 · 2023: 31 · 2022: 13 · 2021: 2
- FWCI
- 12.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Diabetes Science and Technology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Leona M. and Harry B. Helmsley Charitable Trust
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 1 diabetes, continuous glucose monitoring, glycemic control, HbA1c, diabetic ketoacidosis, severe hypoglycemia, sociodemographic disparities, insurance status, race and ethnicity, T1D Exchange, endocrinology clinic, quality improvement
- MeSH terms
- Aged, Blood Glucose, Demography, Diabetes Mellitus, Type 1, Medicare, Humans, Hypoglycemia, United States, Blood Glucose Self-Monitoring, Diabetic Ketoacidosis
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