P-360: Sustained continuous glucose monitoring engagement and glycemic improvement in a predominantly young socioeconomically vulnerable type 1 diabetes population

Abstract

Continuous glucose monitoring (CGM) improves glycemic control in type 1 diabetes (T1D), yet evidence from public health settings in socioeconomically vulnerable young populations remains scarce. To evaluate glycemic outcomes and user engagement with CGM in a predominantly young T1D population followed at a public health clinic in Northeastern Brazil. A 6-month longitudinal study enrolled 53 individuals with T1D. An intermittently scanned CGM device was used throughout follow-up. Glycated hemoglobin (HbA1c) was measured at baseline and at six months. Monthly CGM reports and questionnaires captured glycemic metrics and user behavior. A total of 32 (60.4%) of participants were under 25 years of age. The cohort was mostly self-declared Black or mixed-race (81.1%), with income up to 2 minimum wages (77.4%). HbA1c decreased from 9.7±1.19% to 7.9±1.86% over six months. In the under-25 group, baseline HbA1c was 9.08±1.92%, decreasing to 8.37±1.83% at six months. Across the full cohort, sensor active time was 80.7%, time in range 48.5%, and glucose management indicator 7.6%. Daily scans averaged 8.7, with near-universal nocturnal monitoring (95.9%). Median daily scan frequency differed across age groups: 6.6 in children under 12, 14.9 in adolescents, and 17.2 in adults aged 18-25 years. Most participants (77%) used CGM data to prevent hypoglycemia and 60.4% reported no discrepancy with capillary glucose at six months. Autonomy in scanning rose from 28.3% to 52.1%. Dermatitis was observed in approximately 15% of participants. A high-engagement group (active time equal to or above 70% and 8 or more scans/day) comprised 30.2% of participants. Continuous glucose monitoring promoted glycemic improvement and sustained engagement in a vulnerable population of predominantly young individuals with T1D, reinforcing the need for equitable access policies in public health systems.