Racial and ethnic disparities in rates of continuous glucose monitor initiation and continued use in children with type 1 diabetes

Background: Racial/ethnic disparities in continuous glucose monitor (CGM) use exist among children with type 1 diabetes. It is not known if differential rates of device initiation or sustained use drive this disparity.

Objective: To compare CGM initiation rates and continued use among non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic children.

Methods: Retrospective review including children with type 1 diabetes attending Children’s Hospital of Philadelphia between 1/1/15 and 12/31/18.

Results: Of 1509 eligible children, 726 (48%) started CGM during the study period. More NHW (54%) than NHB (31%) and Hispanic (33%) children started CGM (p < 0.001). One-year after starting, fewer NHB (61%) than NHW (86%) and Hispanic (85%) children were using CGM (p<0.001).

Conclusions: Lower CGM use in NHB children was due to lower rates of device initiation and higher rates of discontinuation. Interventions to address these barriers are needed to reduce disparities in CGM use.