title: Real-time continuous glucose monitoring among participants in the T1D Exchange clinic registry.
abstract: OBJECTIVE
  To assess the frequency of continuous glucose monitoring (CGM) device use, factors associated with its use, and the relationship of CGM with diabetes outcomes (HbA1c, severe hypoglycemia [SH], and diabetic ketoacidosis [DKA]).
  
  
  METHODS
  Survey questions related to CGM device use 1 year after enrollment in the T1D Exchange clinic registry were completed by 17,317 participants. Participants were defined as CGM users if they indicated using real-time CGM during the prior 30 days.
  
  
  RESULTS
  Nine percent of participants used CGM (6% of children <13 years old, 4% of adolescents 13 to <18 years, 6% of young adults 18 to <26 years, and 21% of adults ≥26 years). CGM use was more likely with higher education, higher household income, private health insurance, longer duration of diabetes, and use of insulin pump (P < 0.01 all factors). CGM use was associated with lower HbA1c in children (8.3% vs. 8.6%, P < 0.001) and adults (7.7% vs. 7.9%, P < 0.001). In adults, more frequent use of CGM (≥6 days/week) was associated with lower mean HbA1c. Only 27% of users downloaded data from their device at least once per month, and ≤15% of users reported downloading their device at least weekly. Among participants who used CGM at baseline, 41% had discontinued within 1 year.
  
  
  CONCLUSIONS
  CGM use is uncommon but associated with lower HbA1c in some age-groups, especially when used more frequently. Factors associated with discontinuation and infrequent use of retrospective analysis of CGM data should be considered in developing next-generation devices and education on CGM use.
authors.affiliation: Madison Clinic for Pediatric Diabetes and University of California San Francisco, San Francisco, CA.
authors.forename: Jenise C
authors.initials: JC
authors.lastname: Wong
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Foster
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Aurora, CO.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Dan
authors.initials: D
authors.lastname: Raghinaru
authors.affiliation: International Diabetes Center Park Nicollet, Minneapolis, MN.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Bergenstal
authors.affiliation: Harold Schnitzer Diabetes Health Center at Oregon Health and Science University, Portland, OR.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ahmann
authors.affiliation: Keck School of Medicine of the University of Southern California, Los Angeles, CA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
authors.affiliation: Atlanta Diabetes Associates, Atlanta, GA.
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Bode
authors.affiliation: Northwestern University, Chicago, IL.
authors.forename: Grazia
authors.initials: G
authors.lastname: Aleppo
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Irl B
authors.initials: IB
authors.lastname: Hirsch
authors.affiliation: Helen DeVos Children's Hospital, Grand Rapids, MI.
authors.forename: Lora
authors.initials: L
authors.lastname: Kleis
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Aurora, CO.
authors.forename: H Peter
authors.initials: HP
authors.lastname: Chase
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: DuBose
authors.affiliation: Jaeb Center for Health Research, Tampa, FL t1dstats@jaeb.org.
authors.forename: Kellee M
authors.initials: KM
authors.lastname: Miller
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.affiliation: Madison Clinic for Pediatric Diabetes and University of California San Francisco, San Francisco, CA.
authors.forename: Saleh
authors.initials: S
authors.lastname: Adi
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D015994:Incidence; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008297:Male; D018670:Monitoring, Ambulatory / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin