Use of Continuous Glucose Monitors in Publicly Insured Youth With Type 2 Diabetes: A 12-month Pilot and Feasibility Study

Background: Type 2 diabetes (T2D) disproportionately affects youth with public insurance of minority and lower socioeconomic status backgrounds. We aimed to determine feasibility of CGM use in this understudied population. Methods: We enrolled youth <20 years old with T2D, provided or prescribed intermittent scanned CGM, and followed established clinic workflows with six data collection visits over 12-months. CGM use was measured by % wear time per two-week period (>75% wear-time as goal) from downloaded report prior to clinic visit. Exploratory outcomes included: 14-day CGM wear time in range (TIR: % time spent between 70 and 180 mg/dl), HbA1c, and patient-reported outcomes (PROs) collected from youth and parents. Results: We enrolled 30 youth (age 15.1 years [SD 2.48]; HbA1c 10.2%, range: 6.5%-15.5%), 46.7% female, 90% Hispanic. At baseline, 37% previously used CGM and 53% lacked glucometer data. CGM use was 50% at three months and 23% at 12 months. CGM wear time decreased by 6.4 days per two weeks by 12 months. Mean HbA1c was 9.8% at 12 months and median TIR decreased from 71% to 42%. Parents and youth had moderate-to-positive attitudes about diabetes technology. Youth endorsed fair levels of global health; and youth and parents endorsed fair general and diabetes-related health-related quality of life. Conclusions: Strategies for sustained CGM use in youth with T2D may differ from adults with T2D or youth with type 1 diabetes. Additional studies are needed to evaluate facilitators and barriers of sustained CGM use to optimize CGM use in youth with T2D. Clinicaltrials.gov registration: NCT05074667.