OBJECTIVES : Continuous glucose monitoring (CGM), an alternative to self-monitoring of blood glucose (SMBG) for adults with type I or type II diabetes, has continued to improve in both accuracy and accessibility since first approved by the FDA in 1999. This study examined trends in CGM among US adults with type I diabetes from 2017 to 2020.

METHODS : Data on US adults were analyzed from the 2017, 2018, 2019, and 2020 National Health and Wellness Survey (NHWS), a nationally-representative, cross-sectional online survey. Analysis sample from each year included respondents who self-reported both diagnosis of type I diabetes and use of insulin. Results were weighted to be representative of the US population.

RESULTS : Among US adults with type I diabetes, self-reported use of any glucose tester or monitor was 94.3% in 2017, 94.4% in 2018, 91.8% in 2019, and 92.6% in 2020. Among these adults, self-reported use of CGM was 36.0% in 2017, 38.4% in 2018, 44.8% in 2019, and 55.3% in 2020. Overall, across all adults with type I diabetes, use of CGM increased from 33.9% to 51.2% over the last four years. Among US adults with type I diabetes in 2020, those using CGM were younger on average than those using SMBG (43.0±1.07 vs. 47.3±1.54; p=0.004). Similarly, when compared to all other adults with type I diabetes, those using CGM were more likely to be married/living with a partner (62.3% vs. 49.1%; p=0.012) and have a lower average Charlson comorbidity index (CCI) (1.54±0.11 vs. 2.30±0.34; p=0.007).

CONCLUSIONS : In a broadly representative US population of adults with type I diabetes, self-reported use of CGM increased from 33.9% to 51.2% from 2017 to 2020, becoming the preferred glucose test or monitor. Comparisons of CGM users versus those using SMBG indicated a significant age gap.