CGM users see more time in range during early weeks of COVID-19 pandemic
Most people with diabetes who used continuous glucose monitoring during the first 8 weeks of the COVID-19 pandemic improved their time in range, although the benefits varied by region and socioeconomic status, according to study data.
“[The findings] clearly show that glucose control was well maintained or time in range improved by 2%,” Satish Garg, MD, professor of medicine and pediatrics at the Barbara Davis Center for Diabetes, University of Colorado Denver, told Healio. “There was nearly a twofold increase in the number of patients who had an increase in the time in range by 5%.”
Garg and colleagues conducted a retrospective review of data from 65,067 Dexcom G6 CGM users in the United States. All participants started using the CGM on or before Jan. 1, 2020, used the mobile app to view data, had at least one sensor glucose value each month during the first half of 2020, and uploaded at least 200 sensor glucose values per day for at least 4 days per week in the pre-pandemic and intra-pandemic time periods. The pre-pandemic period consisted of the first 8 weeks of 2020 ending on March 1, and the intra-pandemic period lasted 8 weeks through June 14. The findings were published in Diabetes Technology and Therapeutics.
When comparing time in range pre-pandemic vs. during the pandemic, the study population had a mean increase of 2% (P < .001). Improved time in range was observed in 59.4% of CGM users, and the proportion of people meeting a goal of 70% time in range or higher increased from 31.7% before the pandemic to 36.4% during the pandemic (P < .001). Compared with the pre-pandemic period, 32.9% of users had a time in range increase of at least 5%, whereas only 18.6% had a time in range decrease of at least 5%.
Time-in-range improvements varied based on income and regional disparities. Mean time in range was generally higher for those living in a ZIP code with a higher median income. Those living in a ZIP code with a median household income of $150,000 or higher per year had a 2.9% time-in-range improvement, whereas those living in an area with a median income of $50,000 or less had an improvement of 1.4%. Garg said the findings highlight the disparities some members of the diabetes community face.
“There could be a variety of factors responsible for these differences. Part of this could be due to inadequate education,” Garg said. “Part of this could be people have been recently initiated on the CGM or lack of resources.” Regional time in range was broken down according to CDC-designated Integrated Food Safety Centers of Excellence regions. The highest mean time-in-range values before and during the pandemic were found in the 10-state region headquartered in Denver, and the largest improvement in time in range was observed in people living in the seven-state region headquartered in Seattle, the researchers wrote.
Garg said the findings are further evidence of the value of CGM and show remote monitoring of diabetes and telehealth could be options for those with diabetes long term.
“The use of CGM, especially during the pandemic, is clinically important and should be reimbursed [by insurance],” Garg said. “In addition, telehealth should be here to stay, even after the pandemic is over.”
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Satish K. Garg, MD, can be reached at firstname.lastname@example.org.