The 2024 National Report on Continuous Glucose Monitoring Uptake in Pediatric Type 1 Diabetes Following Universal Funding in Aotearoa New Zealand: Early Findings from the KiwiDiab Pediatric Diabetes Network

Aim: To describe national patterns in continuous glucose monitoring (CGM) uptake and glycemic patterns among children with type 1 diabetes (T1D) in Aotearoa New Zealand following universal CGM funding on October 1, 2024. Methods: Data from the KiwiDiab pediatric diabetes network for 2024 included children <16 years with T1D who were attending 14 regional pediatric diabetes centers. CGM uptake was evaluated using the weekly proportion using CGM and the weekly proportion initiating CGM. Overall and ethnicity-specific initiation was analyzed using negative binomial regression of weekly initiation counts, with the number not using CGM at the start of each week as an offset, comparing prefunding, rollout, and postfunding periods. HbA1c measurements were summarized as cross-sectional monthly distributions by prioritized ethnicity. Results: In total, 1681 children and adolescents with T1D were included. Mean weekly proportions initiating CGM increased from 1.4% prefunding to 12.9% during rollout (incidence rate ratio [IRR] = 9.05, 95% confidence interval [CI]: 5.03–17.5) and remained elevated postfunding at 6.6% (IRR = 4.64, 95% CI: 3.27–6.61). During rollout, mean weekly proportions initiating CGM increased from 1.0% to 14.0% among Māori, from 0.8% to 11.6% among Pacific, from 1.5% to 15.9% among Asian, and from 1.8% to 11.0% among European children. There was no statistically significant evidence that the magnitude of change across funding periods differed by ethnicity (period-by-ethnicity interaction, P = 0.72). Differences in the proportion using CGM between ethnic groups narrowed during 2024 but remained at year-end. Cross-sectional HbA1c distributions remained relatively stable throughout 2024, with no clear early lowering observed. Conclusion: Universal CGM funding was associated with a rapid increase in CGM uptake across Aotearoa New Zealand. CGM initiation increased markedly across ethnic groups, and ethnic disparities in CGM use narrowed during 2024, although they persisted at year-end.