Continuous glucose monitor use varies by age, highest in middle adulthood
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Among people with type 1 diabetes, continuous glucose monitor use varied across the life span, with the highest likelihood of use reported in middle adulthood, according to study data.
In a cross-sectional study, Joshua M. Weinstein, MPP, a doctoral student in the department of health policy and management at the University Of North Carolina Gillings School of Global Public Health, and Anna R. Kahkoska, MD, PhD, assistant professor in the department of nutrition at the University of North Carolina, sought to determine the age-based probability of using CGM, which they wrote is the standard for glucose monitoring for type 1 diabetes, and also to determine the association of CGM use with glycemic control across the life span.
The study included individuals aged 10 to 85 years from the national T1D Exchange Registry (2017-2018), which includes data from 80 U.S. clinics nationwide culled via medical record extraction and patient questionnaires. Researchers controlled for health insurance, sex, annual household income, education level, race and ethnicity, and insulin delivery method.
In all, 19,261 people (mean age, 27.58 years) with type 1 diabetes were included. Among them, 50.59% were girls and women, 49.21% were boys and men, and in 0.2% of cases the sex was unknown. Mean HbA1c level was 8.57%, and 30% of patients indicated CGM use.
Researchers found that the adjusted probability of CGM use fell during adolescence, rose afterward until roughly age 40 years, stayed fairly constant until age 60 years, and then fell again until age 75 years. Compared with nonuse, CGM use was associated with lower HbA1c levels across age groups, though this relationship waned with increased age.
Furthermore, compared with nonusers, CGM users had the following adjusted mean differences in HbA1c levels: age 10 years, 0.7%; age 20 years, 0.62%; age 30 years, 0.55%; age 40 years, 0.48%; age 50 years, 0.41%; age 60 years, 0.34%; age 70 years, 0.27%; age 80 years, 0.2%; and age 85 years, 0.16%.
“We found that, among individuals in the T1D Exchange Registry, the probability of CGM utilization is highest in middle adulthood,” Weinstein told Healio. “The probability of CGM utilization decreased with increasing age beyond middle adulthood, which likely reflects barriers that Medicare patients used to face in acquiring CGMs. Medicare recently changed their CGM coverage policies in 2021 to reduce barriers to access, so it is likely that CGM utilization rates among older adults in the United States will increase in the near future.”
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