2079-P: Continuous Glucose Monitoring (CGM) Wear Time and Sustained Use in Newly Diagnosed vs. Established Youth with Type 2 Diabetes (T2D)

Abstract

Introduction and Objective: CGM use in youth with T2D remains limited, with sparse longitudinal data on engagement. Emerging evidence suggests early CGM initiation at diagnosis may support improved glycemic monitoring and reduced diabetes-related burden in youth with T2D. Our objectives were to compare CGM wear time and engagement in youth with a newer diagnosis of T2D compared to those with an established diagnosis (≥1 year). Methods: Twenty participants were randomized in a 2:1 ratio to use CGM (FreeStyle Libre 3) or blood glucose (BG) meters for 6 months. CGM use was assessed by % wear time over a four-week period. Youth with T2D randomized to the treatment arm were stratified by diabetes duration as newly diagnosed (ND, <1 year) or established diagnoses (ED, ≥1 year). CGM wear time was compared between groups using linear mixed effects models for group-by-time comparison, t-test, and Welch’s t-test for wear over time. Results: ND youth (n=4) exhibited a trend towards increased consistency of device wear with a mean wear time of 56% compared to ED youth, 44% (n=9, P=0.6). Despite higher mean wear in the ND group, consistent device wear varied substantially. Wear time among ND participants declined after month 2 by an additional 9.4% per month (P=0.01), indicating a decrease in sustained use. Participants with ED demonstrated lower initial CGM use but greater consistency over time. Conclusion: ND youth with T2D demonstrated greater early CGM engagement than those with established disease, though device use declined over time. Youth with ED showed a stable trend in CGM use although they had consistently lower median wear time. These findings support early CGM initiation at diagnosis while underscoring the need for targeted strategies to sustain long-term adherence in youth with T2D. Further studies are warranted to help identify barriers to consistent CGM use among youth. Disclosure A. Narayan: None. S.I. Wyszynski: None. M.C. Yuasa: None. Z. Perez: None. C. Trujillo: None. H. Chesser: Research Support; Current; BioMarin Pharmaceutical Inc. L. Ekhlaspour: Advisory Panel; Current; Abbott Diabetes. Research Support; Current; Abbott Diabetes. Consultant; Current; Tandem Diabetes Care, Inc. Research Support; Current; Tandem Diabetes Care, Inc. Consultant; Ended; Jaeb Center for Health Research. Advisory Panel; Current; MannKind Corporation. Research Support; Current; MannKind Corporation. Advisory Panel; Current; Medtronic. Research Support; Current; Medtronic. Advisory Panel; Current; Sequel. Speaker's Bureau; Current; Tandem Diabetes Care, Inc. Other - Received honorarium for a presentation at ADA; Current; Medtronic. Advisory Panel; Current; Sanofi. Other - Received honorarium for a Sanofi-sponsored grant for garndrounds; Ended; Med Learning Group. Advisory Panel; Current; Diabetes Center Bern. Speaker's Bureau; Ended; Insulet Corporation. Other - Rceived honorarium for presenting at an education event sponsored by MannKind; Current; Children with Diabetes. Research Support; Current; Breakthrough T1D, Sanofi. Other - Presented at a Mannkind Sponsored program; Current; CGMEducation.net. Research Support; Current; Helmsley Trust. S. Srinivasan: Research Support; Current; Abbott, Eli Lilly and Company. J.C. Wong: Research Support; Ended; Abbott Diabetes.