2059-LB: Practice Insights on Continuous Glucose Monitoring (CGM) Utilization in Diabetes Care

Introduction and Objective: Continuous Glucose Monitoring (CGM) is a critical tool for diabetes management, yet its utilization remains underreported. This study evaluates the feasibility of reporting CGM utilization rates among adults with diabetes, examining uptake, variations by diabetes type, and clinician differences. Methods: A mixed-methods design assessed CGM utilization among 11,270 patients (age 18-39: 8%, 40-75: 92%; type 1: 4%, type 2: 96%) managed by 79 clinicians in 12 sites. Quantitative data included aggregated clinician results and de-identified patient uptake from automated queries of EHRs and manual chart reviews in 2023. Uptake and clinician variations were calculated using aggregated data. Feasibility was evaluated by ranking data element identification via automated queries and qualitative insights about reporting challenges. Data validity was evaluated by pooling results across sites and comparing automated queries to manual reviews, assessing sensitivity, specificity, and predictive values Results: The CGM utilization rate was 5%. Utilization was highest for type 1 diabetes (30%), followed by type 2 diabetes with multiple daily injections, basal insulin or hypoglycemic events (28%). Clinician rates varied widely, with type 1 ranging from 0% to 100% (median 25%), type 2 showing similar medians but narrower variability. Feasibility assessments highlighted challenges in identifying continuous insulin infusion users, CGM metrics, and Ambulatory Glucose Profile reports, due to unstructured documentation and inconsistent EHR capture. Validity testing showed high specificity (99%) but low sensitivity (48%), emphasizing reliance on manual reviews to ensure comprehensive and accurate data. Conclusion: CGM utilization showed significant variability across clinicians and patient groups; low adoption points to gaps in implementation despite guidelines. CGM use among individuals with type 1 diabetes was low, even though strong evidence supports its benefit. Disclosure X. Zhou: None. E. Hubbard: None. K.D. Bishop: None. E. Jun: None. N. Herdzik: None. S.A. Trivette: None. K. Onstad: None. C. Blaum: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust