916-P: Early CGM Initiation with Remote Monitoring Improves A1C in Youth with T1D

Previous studies have shown that CGM use and frequent contact with the care team is associated with improved A1c. We hypothesized that youth with new onset T1D started on CGM with weekly CGM data review by a CDE would have improved outcomes compared to those on CGM alone. Youth with newly diagnosed T1D from 7/2018 to 3/2019 were started on CGM alone (control, n=46) while those from 3/2019 to 5/2020 were started on CGM with weekly data review by a CDE (GluVue, n=76). Dose adjustments were made via secure messaging. We visualized A1c trajectories using locally estimated scatter plot smoothing (Fig) and assessed for differences in A1c trajectory by GluVue status via cohort*time and cohort*time2 interaction terms in a linear mixed model regression adjusted for baseline characteristics (age, sex, race and insurance type). The mean (SD) A1c at diagnosis was 12.0% (1.8) in the control group and 12.3% (2.3) in the GluVue group. Baseline characteristics of control vs. GluVue: male 25% vs. 39%, Non-Hispanic White 41.3% vs. 35.5%, private insurance 80.4% vs. 73.7%. Mean A1c of the GluVue cohort was lower at 6 months (-0.45%), 9 months (-0.07%), and 12 months (-0.52%) post-diagnosis. A1c trajectories were significantly different between groups via regression analysis (p=0.004). Early initiation of CGM with remote monitoring was associated with lower A1c compared to CGM alone. These data support early CGM initiation plus care team contact in youth with T1D. Disclosure P. Prahalad: None. K. K. Hood: Consultant; Self; Cecelia Health, Cercacor, LifeScan Diabetes Institute. D. Scheinker: Advisory Panel; Self; Carta Healthcare. M. Desai: None. D. M. Maahs: Advisory Panel; Self; Abbott Diabetes, Dompe, Eli Lilly and Company, Medtronic, Novo Nordisk, Consultant; Self; aditxt. V. Ding: None. B. Leverenz: None. J. Hooper: None. J. Leverenz: None. P. Sagan: None. A. Martinez-singh: None. A. Freeman: None. D. P. Zaharieva: None. Funding National Institutes of Health (P30DK116074, R18DK122422)