Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study
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Abstract
OBJECTIVE: Continuous glucose monitoring (CGM) is increasingly used in type 1 diabetes management; however, funding models vary. This study determined the uptake rate and glycemic outcomes following a change in national health policy to introduce universal subsidized CGM funding for people with type 1 diabetes aged <21 years. RESEARCH DESIGN AND METHODS: Longitudinal data from 12 months before the subsidy until 24 months after were analyzed. Measures and outcomes included age, diabetes duration, HbA1c, episodes of diabetic ketoacidosis and severe hypoglycemia, insulin regimen, CGM uptake, and percentage CGM use. Two data sources were used: the Australasian Diabetes Database Network (ADDN) registry (a prospective diabetes database) and the National Diabetes Service Scheme (NDSS) registry that includes almost all individuals with type 1 diabetes nationally. RESULTS: CGM uptake increased from 5% presubsidy to 79% after 2 years. After CGM introduction, the odds ratio (OR) of achieving the HbA1c target of <7.0% improved at 12 months (OR 2.5, P < 0.001) and was maintained at 24 months (OR 2.3, P < 0.001). The OR for suboptimal glycemic control (HbA1c ≥9.0%) decreased to 0.34 (P < 0.001) at 24 months. Of CGM users, 65% used CGM >75% of time, and had a lower HbA1c at 24 months compared with those with usage <25% (7.8 ± 1.3% vs. 8.6 ± 1.8%, respectively, P < 0.001). Diabetic ketoacidosis was also reduced in this group (incidence rate ratio 0.49, 95% CI 0.33–0.74, P < 0.001). CONCLUSIONS: Following the national subsidy, CGM use was high and associated with sustained improvement in glycemic control. This information will inform economic analyses and future policy and serve as a model of evaluation diabetes technologies.
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After CGM use increased in Australia following the introduction of public funding, HbA1c and rates of DKA were reduced.
“After CGM use increased in Australia following the introduction of public funding, HbA1c and rates of DKA were reduced.”
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 [35]
The Conclusions report that mean HbA1c fell after subsidized CGM was introduced for Australians with type 1 diabetes aged under 21. However, the Conclusions say there was no clinically significant change in DKA rates in the overall sample; the reduction reported under Rates of Usage and Glycemic Outcomes was limited to those using CGM more than 75% of the time compared with those using it less than 25% of the time. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe 2017 Australian Government funding of continuous glucose monitoring for people younger than 21 years with type 1 diabetes led to an increase in continuous glucose monitoring use from approximately 5% to 79% among this cohort.
“In 2017, the Australian Government fully funded continuous glucose monitoring products for people younger than 21 years of age with type 1 diabetes. This led to an increase in continuous glucose monitoring use from approximately 5% to 79% among this cohort.28”
From Blood glucose monitoring devices: current considerations (2023) · cites this paper as [28]
Within two years after the introduction of public funding of CGM in Australia for youth with T1D, 79% used CGM.
“Within two years after the introduction of public funding of CGM in Australia for youth with T1D, 79% used CGM, a similar proportion as in our results.”
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14. Children and Adolescents: Standards of Care in Diabetes—2025
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Digital Technology for Diabetes
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Blood glucose monitoring devices: current considerations
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- Authors
- Johnson, S. R., Holmes-Walker, D. J., Chee, M., Earnest, A., & Jones, T. W.
- Affiliations
- The University of Queensland (AU)
- The University of Sydney (AU)
- Juvenile Diabetes Research Foundation (AU)
- Monash University (AU)
- The Kids Research Institute Australia (AU)
- Corresponding author
- Jones, Timothy W.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-12-06
- Volume
- 45
- Issue
- 2
- Pages
- 391-397
- ISSN
- 0149-5992 (ISSN-L)
- PMC
- PMC8914416
- OpenAlex
- W4200450426
- Cited by
- 86
- References
- 6
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 27 · 2023: 18 · 2022: 12
- FWCI
- 10.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- Bond University Research Portal (Bond University) (publishedVersion, other-oa)
- UWA Profiles and Research Repository (UWA) (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Juvenile Diabetes Research Foundation Australia
- Australian Research Council
- 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
- continuous glucose monitoring, type 1 diabetes, health policy, glycemic control, HbA1c, diabetic ketoacidosis, severe hypoglycemia, young adults, technology adoption
- MeSH terms
- Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, Blood Glucose Self-Monitoring, Young Adult
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