Introduction and Objective: CGM is the standard of care for adults with T1D and a necessary component of automated insulin delivery (AID) systems; yet, barriers to CGM adoption and use remain. The ONBOARD study gave adult CGM non-users a 3-month supply of CGM and tracked rates of sustained uptake for 12 months. This study aimed to examine differences between CGM users and non-users after 1 year. Methods: 134 adult CGM non-users with T1D participated in assessments at baseline, and 3-, 6- and 12-months after CGM uptake. Data collected included: demographic and medical information, HbA1c, CGM metrics, diabetes distress (T1-DDS) and glucose monitoring satisfaction (GMSS-T1D). For discontinuers, we collected reasons for non-use. T-tests and Chi-Square or Fisher’s exact tests assessed differences between CGM users and non-users. Results: At baseline, participants were 77% female, with a mean age of 35±8 years, mean HbA1c of 8±1.9%, and 55% not on insulin pumps. At 3-months after CGM initiation, 86 participants reported CGM use (73%) and 32 (27%) had discontinued. Groups did not differ by HbA1c, distress, or glucose monitoring satisfaction, but CGM users were more likely to see an endocrinologist (79%) or PCP 17%) for T1D care compared to non-users (endocrinologist 72%, PCP 13%; 13% did not have a provider). At 12-months, 74% reported CGM use and 26% reported no CGM use. Non-users cited device cost (60.7%), supply cost (64.3%), discomfort/pain (14.3%), dislike of wearing device (14.3%), and inaccuracy (14.3%) as reasons for discontinuation. CGM users had lower HbA1c (7.1±1.4%) than non-users (8.5±2.5%; p=.005). CGM users had higher glucose monitoring satisfaction than non-users (p=.002). No significant difference in diabetes distress was observed between the groups. Conclusion: Most participants who adopted CGM in the study sustained use and experienced glycemic benefit; however, roughly one-quarter discontinued CGM due to barriers. Addressing barriers to CGM adoption and sustained use is essential for broader implementation of AID systems. Disclosure M.B. Pasmooij: None. S. Hanes: None. H. Darji: None. M. Basina: None. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. M.L. Tanenbaum: Speaker's Bureau; Current; Beta Bionics, Inc. Other - Honoraria; Ended; Sanofi. Funding National Institutes of Health (K23DK119470, R03DK135840)
Pasmooij et al. (Fri,) studied this question.