How likely are those who report an A1c of <6.5% to use insulin pump or continuous glucose monitoring (CGM) technology vs. those with an A1c of >8%? Are there differences in the way these individuals make use of the technology?
In this second installment of our data-driven article series, we aimed to find out the connections between insulin pump and CGM use and self-reported A1c levels. Because very few individuals with type 2 diabetes reported using this technology in our survey, this article focuses on those with type 1 diabetes. Of note, although the sample size was small, people with type 2 diabetes in the lower reported A1c bracket were significantly more likely to use an insulin pump (~10% (n=11) in the <6.5% A1c group vs. ~3% (n=5) in the >8.0% A1c group).
Among those with type 1 diabetes, several hundred individuals reported on their technology use habits. In addition to collecting data on insulin pump and CGM use, we also asked participants detailed questions about their CGM alert settings.
Insulin Pump and CGM Use Among Patients with Type 1 Diabetes
We identified that a larger proportion of people in the <6.5% A1c bracket reported using insulin pump as well as CGM technology as compared to those with an A1c of >8%. Although more people in the lower A1c bracket reported using both devices concurrently, this metric did not reach statistical significance (35% vs. 29%).
Differences in CGM Alert Settings
Importantly, we found significant differences in the CGM alert setting reported by those in the optimal (<6.5%) A1c group vs. those with higher reported A1c levels (>8%) for both high and low blood glucose alerts. In general, people with a lower reported A1c were more likely to set their hyperglycemia alerts to lower levels. Strikingly, only 31% of those in the lowerA1c bracket reported setting their high alert to 200 mg/dL or higher, as compared to 76% of those who reported higher A1c levels.
Similarly, those with lower reported A1c levels were more likely to have their hypoglycemia alerts programmed to lower levels.
Overall, these data suggest that people who achieve optimal A1c levels are more likely to make use of diabetes technology, including insulin pumps and CGMs. Moreover, the differences observed in the reported CGM settings indicate that there those achieving optimal A1c levels tend to have more narrow target ranges, and presumably act to correct hyperglycemia faster, which may directly translate to the improved glycemic control.
Do you make use of diabetes technology? Has it helped you to improve your management? Please share this report and your thoughts in the comments.
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