1444-P: Trends and Disparities in Continuous Glucose Monitoring Use in U.S. Youth and Adults with Type 1 Diabetes—2008–2022

Introduction: Continuous glucose monitoring (CGM) technology has revolutionized the management of type 1 diabetes. However, trends and disparities in CGM use remain poorly characterized in general type 1 diabetes population. Methods: We conducted a serial cross-sectional analysis of youth and adults with type 1 diabetes using de-identified electronic health record data from the Optum Labs Data Warehouse. Type 1 diabetes status was determined using a validated algorithm. Use of CGM was ascertained by National Drug Codes from prescription order data. We examined trends in CGM use from 2008-2010 to 2020-2022, overall and by age, sex, race/ethnicity, and insurance type. Results: We included 128,821 individuals with type 1 diabetes (17% under age 18 years; 48% female; 78% non-Hispanic White). From 2008-2010 to 2020-2022, the use of CGM increased from <1% to 47% in youth and 2% to 37% in adults with type 1 diabetes (Fig A1 and A2). Uptake of CGM was similar across age and sex, but substantially lower in racial/ethnic minority patients and those with Medicaid insurance (Fig B1-E2). Conclusion: Over the past 15 years, the use of CGM has grown significantly among persons with type 1 diabetes in the US. However, racial/ethnic and socioeconomic disparities have widened in both youth and adults. There is an urgent need to expand access to care and diabetes technology to improve care in this population. Disclosure M. Fang: None. Y. Xu: None. J. Coresh: Consultant; SomaLogic, Healthy.io. S. Ballew: None. E. Selvin: None. J. Shin: None. Funding K01 DK138273-01