Introduction and Objective: Continuous glucose monitors (CGMs) support diabetes self-management in adults with type 2 diabetes. However, patterns of CGM use and the characteristics of patients who benefit most in real-world healthcare settings remain unclear. This study examined factors associated with CGM uptake and glycemic control within a large Southern California health system. Methods: We conducted an observational study of adults with type 2 diabetes who received a CGM referral order at Kaiser Permanente Southern California between Feb-Oct 2025. CGM users were patients with continuous CGM data documented in the EHR. Demographics and clinical characteristics were extracted from the EHR. Adjusted logistic regression models were used to identify correlates of 1) CGM uptake and 2) achieving A1c 7% among those with elevated baseline A1c. Results: Among 25,392 adults with a CGM referral order, 14,345 were CGM users. In adjusted logistic regressions, lower odds of CGM use were observed for older age (OR = 0.99; 95% CI: 0.98-0.99), Spanish language preference (OR = 0.43; 95% CI: 0.39-0.48), government insurance (OR = 0.92; 95% CI: 0.85-0.99), higher neighborhood deprivation (most vs. least deprived: OR = 0.81; 95% CI: 0.76-0.90), and higher baseline A1c (OR = 0.79; 95% CI: 0.77-0.80). Among CGM users, mean A1c decreased from 8.3% to 8.0% at three months, and 21% with baseline A1c ≥7% achieved A1c 7%. In adjusted models for glycemic control, older age (OR = 0.97; 95% CI: 0.96-0.99), Spanish language (OR = 0.27; 95% CI: 0.15-0.46), and highest neighborhood deprivation (OR = 0.56; 95% CI: 0.39-0.82) were associated with lower odds of achieving A1c 7%, while higher BMI modestly increased the odds (OR = 1.03; 95% CI: 1.01-1.05). Conclusion: In this real-world setting, older adults, Spanish-speaking patients, and those in highly deprived neighborhoods were less likely to initiate CGM and less likely to achieve glycemic control post CGM referral. Expanding access and providing targeted support for these groups may improve equity and maximize CGM’s clinical impact. Disclosure T. Formagini: None. M. Macias: None. J. Martin: None. G. Tejada: None. T. Hsieh: None. T. Chuang: None. W. Wakach: None. K.J. Coleman: None. Funding Kaiser Permanente Southern California Care Improvement Research Team (KPSC CIRT)
Formagini et al. (Fri,) studied this question.