Impact of Type 1 Diabetes on Productivity and Out-of-Pocket Costs of Adult Continuous Glucose Monitoring Users in the United States: Results From a Cross-Sectional Survey in the United States

OBJECTIVES: In the United States, type 1 diabetes (T1D) affects an estimated 1.4 million individuals, with an estimated annual incidence of 64,000 diagnoses. T1D is an incurable, life-limiting disease. Individuals with T1D are impacted by a multitude of challenges, including financial constraints and impairments to work and life productivity. The self-reported economic impact of T1D on adults is not well quantified, which this study aims to investigate.

METHODS: Adult continuous glucose monitor (CGM) users (aged ≥18 years) from the T1D Exchange Registry with a self-reported T1D diagnosis of ≥5 years completed an online survey, including measures of work and life productivity impairment (Diabetes Productivity Measure [DPM]; score 0–100; higher score = greater productivity) and bespoke questions on out-of-pocket (OOP) expenses associated with T1D care, as part of a larger study. Work productivity was calculated for the subset of participants who reported full- or part-time employment. Descriptive analyses (mean [standard deviation (SD)]) of characteristics and patient-reported productivity outcomes are reported for the overall participant population.

RESULTS: Participants’ (N=1,847) mean age was 45.9 years [SD: 15.3]. Most were female (67.5%), were Caucasian (90.7%), had a bachelor’s degree or higher (72.2%), and were employed full- or part-time (n=1,266 [68.5%]). Mean duration of T1D diagnosis was 29 years [SD: 15.1]. Mean self-reported most recent HbA1c value was 6.7% [SD: 1.0]. On the DPM, participants reported a mean score of 68.0 [SD: 19.4] for life productivity and 82.7 [SD: 15.3] for work productivity. Annual mean OOP costs associated with T1D care were $2,570 [SD: $4,433], and 38.6% of participants reported spending ≥$2,500 per year on T1D-associated OOP costs.

CONCLUSIONS: Adult CGM users with T1D experienced impaired productivity and substantial OOP costs, despite their high socio-economic status and use of advanced diabetes technology.