7, 8, 9 CGM is already an established standard of care for type 1 diabetes 10, 11 and is used by approximately 40–50% of people with type 1 diabetes. A CGM can provide data on glucose values that can be viewed easily, tracked over time, and virtually monitored to promote behavior change, avoid hyperglycemia and hypoglycemia, and inform dosing for prandial insulin. 6Ī continuous glucose monitor (CGM) is a wearable medical device that measures real-time glucose levels in subcutaneous interstitial fluid. 5 Furthermore, diabetes is associated with a lower quality of life and the prevalence of elevated diabetes-related distress is estimated at 36%. 5 The most recent data indicate fewer than half are meeting these targets. 4 Despite improvements in medications used to treat diabetes, data from 1999 to 2018 show fewer people with type 2 diabetes meeting glycemic or blood pressure targets over time. 1, 3 About 1 in 10 Americans have diabetes and approximately 90–95% have type 2 diabetes. 1 Costs are expected to increase as incidence and prevalence continue to rise. 1, 2 Diabetes is associated with decreased lifespan and accounts for 1 in every 4 US healthcare dollars. These trends present opportunities for healthcare system adaptations to support CGM use and related workflows in primary care to support growth in uptake.ĭiabetes persists as a major healthcare issue in the United States and worldwide with increasing incidence, management cost, and societal impact. ConclusionĬGM uptake for type 2 diabetes is increasing rapidly, with most growth in primary care. 49% starting in primary care), whereas 28% starting CGM in primary care were not using insulin (vs. Most starting CGM in endocrinology had an intensive insulin regimen (82% vs. From 2020 to 2021, monthly rates of CGM prescriptions to new users grew 36% overall, but 125% in primary care. For each month in 2021, a mean of 90.5 (SD 12.5) people started using CGM. CGM users were more likely to receive endocrinology care than non-users, but 23% had only primary care visits in 2021. CGM users had higher hemoglobin A1c values (both most recent and most proximal to the first CGM prescription) than non-users. CGM users were younger and more had private health insurance ( p < .05) as compared to non-users 72% of CGM users had an intensive insulin regimen, but 12% were not taking insulin. Key ResultsĪmong 30,585 adults with type 2 diabetes, 13% had used a CGM. Main MeasuresĪge, gender, race, ethnicity, insurance, clinic type, insulin regimen, hemoglobin A1c values, CGM prescriptions, and prescribing clinic type. ParticipantsĪdults with type 2 diabetes and a primary care or endocrinology visit during 2021. Retrospective cohort using electronic health records in a large academic medical center in the Southeastern US. We sought to ascertain prevalence and correlates of CGM use and to examine rates of new CGM prescriptions across clinic types and medication regimens. Clinical trials indicate continuous glucose monitor (CGM) use may benefit adults with type 2 diabetes, but CGM rates and correlates in real-world care settings are unknown.
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