Impact on glycaemic outcomes of funding continuous glucose monitoring for youth in Australia

Abstract

Introduction: In April 2017 the Australian Government initiated funding for continuous glucose monitoring (CGM) for eligible under 21 year olds resulting in an acute increase in CGM use in young people in Australia. Although clinical trials have demonstrated a positive effect of CGM use on glycaemic and psychosocial outcomes in T1DM there are as yet few data to describe its impact in real world use. Objectives: The Australasian Diabetes Data Network (ADDN) is a centralised database capturing de-identified coded clinical data from people living with T1DM on a single purpose-built platform. A total of 17 centres are now incorporated into the database, including regional and adult centres in five States. Following the initiation of CGM funding, ADDN was expanded to include a CGM module. This has provided a unique opportunity to evaluate CGM uptake on clinical outcomes for young people with T1DM. Methods: Analysis of CGM outcomes in ADDN participants between 1 April 2017 to 31 December 2018, inclusive, captured 2,724 of the 10,644 youth < 21 years who registered for CGM with the National Diabetes Services Scheme (NDSS) . Results: Of those with documented usage data, HbA1C reduced significantly from 8.3±1.5% at the start of CGM use to 7.9±1.4% at 12 months (p< 0.001) and 7.8%±1.3% at 18 months (p< 0.001) from CGM start. This was associated with an increase in the proportion of patients achieving the recommended HbA1c target of < 7.0%: from 13.1% at start of CGM use to 26.0% 18 months post CGM start. No significant change in severe (coma/convulsion) hypoglycaemia rates (3.08 vs 3.69 events/100 patient years, pre vs 12 months post use) or DKA rates (3.99 vs 4.3 events/100 patient years, pre vs 12 months post use) were observed. Conclusions: This preliminary analysis of the early impact of general availability of CGM for young people with T1DM indicates a positive impact on key glycaemic outcomes in those using the technology.L6318877552020-06-02 <br />