Presentation (CTI)

OBJECTIVES: The continuous glucose monitoring (CGM) devices adoption has been found to improve glycemic outcomes, but access barriers limit its usage among racial minorities and lower socioeconomic status groups. It is still unclear whether these disadvantaged individuals can fully benefit from the CGM after adoption. This study aims to explore if the glycemic benefits of CGM vary by age, race, and socioeconomic background in U.S.
METHODS: Using data from the U.S. Type 1 Diabetes Exchange Registry, individuals observed both at enrollment (2010-2012) and in the year 5 questionnaire (2016-2018) (10,489 individuals) were included. A two-way fixed effect estimation and propensity score matching difference-in-differences approach was fit to explore the association between change in HbA1c outcomes and CGM history, controlling for other health and sociodemographic characteristics.
RESULTS: CGM use increased across all age groups over five years. Participants with higher educational attainment, greater income levels, private insurance, and insulin pump usage were more likely to adopt CGM, while Black Non-Hispanic individuals exhibited significantly lower adoption rates. CGM adoption was associated with improved glycemic control, as evidenced by reduced HbA1c levels (β = -0.23, SE = 0.05). These benefits were more pronounced among individuals from racial minorities (β = -0.58, SE = 0.23) and lower socioeconomic backgrounds (education: β = -0.25, SE = 0.13; income: β = -0.41, SE = 0.18), and those without private insurance coverage (β = 0.42, SE = 0.18).
CONCLUSIONS: CGM use improves glycemic outcomes, with greater benefits for individuals from racial minorities, lower socioeconomic status, and those without private insurance, despite lower adoption rates in these groups. Disparities in diabetes outcomes could be mitigated by reducing the barriers to access and enhancing the effective use of the technology.