Continuous Glucose Monitoring Attrition in Youth With Type 1 Diabetes.
Seema Meighan, Terri H Lipman, Brigit VanGraafeiland and 1 others
PMID 39783011WHAT IT FOUND
Youth with type 1 diabetes who stopped continuous glucose monitoring often did so early, and non-White youth were more likely to stop.
Chart-documented reasons included adhesion problems, dislike on the body, insurance, pain, and inaccurate readings.
Key findings
01Non-White youth were more likely to discontinue CGM: youth who identified as a race other than White were 3.2 times more likely to discontinue, and NHB and Latine youth were 5.0 and 2.8 times more likely than NHW youth, respectively.
02Most discontinuation happened early: the median time to discontinuation was 4 months and 21 days after initiation, and 57% of those who discontinued did so within the first 180 days; among those who discontinued within 180 days, 45% stopped within 30 days and 71% within 3 months.
03The most common clinician-documented reasons for discontinuation were device adhesion problems (18.4%), dislike on the body (10.8%), insurance problems (9.5%), pain with continuous glucose monitor wear (8.3%), and concerns about inaccurate readings (8.2%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective chart review, so it describes records rather than testing any support strategy. CGM stop dates were missing for many youth, and timing analysis only included youth using cloud-based data, not those using dedicated receivers. Reasons for discontinuation came from clinician notes, not directly from youth and caregivers, and were not always explicitly stated. Youth may have given a reason to please provider, and providers may have interpreted reasons differently. The review covered youth seen at a pediatric diabetes center with satellite locations, so it may not apply to other settings.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. Publication types note NIH extramural research support.
The easy way to misread this
Do not conclude that providing adhesive samples or extra CGM education will lower attrition. This was a retrospective chart review, not a trial, and many CGM stop dates and reasons were missing or only clinician-documented.