Delays in Continuous Glucose Monitoring Device Initiation: A Single Center Experience and a Call to Change

Modzelewski, Katherine L.; Murati, Jonila; Charoenngam, Nipith; Rehm, Cassie; Steenkamp, Devin

doi:10.1089/dia.2021.0557

Cited by 11 publications

(14 citation statements)

References 11 publications

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“…Factors related to prescription receipt and device uptake included age, diabetes type, and whether diabetes care was provided in primary care or endocrinology. This pattern contrasts previous observational results in which uptake was related to insurance type and race/ ethnicity, 17,20 suggesting uptake related to DiabetesWise use may vary from uptake following traditional pathways. Together, these findings may also suggest that Dia-betesWise can promote users' self-advocacy, though further changes are needed to ensure equity related to prescription and device receipt.…”

Section: Discussioncontrasting

confidence: 99%

“…One type of inequity observed in the current study was that participants who received diabetes care through a specialty diabetes practice were more likely to receive a prescription and more likely to start a new device than those followed by primary care. Although prior literature has shown access to a certified diabetes care and education specialist (CDCES), 20 post hoc analyses in the current study did not show a significant relation between access to a CDCES and requesting or receiving prescriptions or new device uptake after interacting with DiabetesWise (all p > .05). Several possible barriers outside of CDCES access could explain this pattern.…”

Section: Discussioncontrasting

confidence: 95%

“…Regarding past device use, results showed that CGM use prior to interacting with DiabetesWise was associated with being female, younger age, type 1 diabetes, and receiving care in a large/academic medical center. These findings coincide with prior observations of females being more likely to use insulin pumps than males 19 and greater CGM 20 and insulin pump use 21 among younger compared to older people with type 1 diabetes. Higher baseline diabetes distress was the only factor associated with whether participants asked their provider for a new device prescription after interacting with DiabetesWise.…”

Section: Discussionsupporting

confidence: 90%

See 2 more Smart Citations

DiabetesWise: An innovative approach to promoting diabetes device awareness

Wong

Addala

Hanes

et al. 2023

Journal of Diabetes

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Background DiabetesWise is an unbranded, data‐driven online resource that tailors device recommendations based on preferences and priorities of people with insulin‐requiring diabetes. The objective of this study is to examine whether DiabetesWise increases uptake of diabetes devices, which are empirically supported to improve glycemic and psychosocial outcomes. Methods The sample included 458 participants (Mage = 37.1, SD = 9.73; 66% female; 81% type 1 diabetes) with insulin‐requiring diabetes and minimal diabetes device use at enrollment. Participants used DiabetesWise and completed online surveys. Chi‐square and t tests evaluated requests for a device prescription, receiving a prescription, and starting a new device at 1 and 3 months post use. Baseline predictors of these variables and past use of continuous glucose monitors (CGMs) and changes in diabetes distress post use were also examined. Results Within the first month of interacting with DiabetesWise 19% of participants asked for a prescription for a diabetes device. This rate rose to 31% in the first 3 months. These requests resulted in 16% of the sample starting a new device within the first 3 months. Whereas several factors were associated with prior CGM use, receiving a prescription, and starting a new device, more diabetes distress (t(343) = −3.13, p = .002) was the only factor associated with asking for a prescription. Diabetes distress decreased after interacting with DiabetesWise within 1 month (t(193) = 3.51, p < .001) and 3 months (t(180) = 5.23, p < .001). Conclusions Within 3 months of interacting with DiabetesWise, one in three participants had requested a prescription for a new diabetes device and average distress levels were reduced, indicating benefit from this low‐intensity online platform.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 95%

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

DiabetesWise: An innovative approach to promoting diabetes device awareness

Wong

Addala

Hanes

et al. 2023

Journal of Diabetes

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show abstract

“…Additionally, some insurance policies require patients to obtain CGMs through durable medical equipment suppliers ( 43 ), rather than through pharmacies in local communities. There is evidence demonstrating that obtaining CGM as a pharmacy benefit is faster than through durable medical equipment companies, thus reducing time-to-initiation of CGM ( 45 ). As added challenges, insurance policies for CGM coverage vary by insurance provider and evolve in response to advances in diabetes technology and most recently the COVID-19 pandemic.…”

Section: Disparities In Cgm Usementioning

confidence: 99%

Continuous glucose monitors and virtual care in high-risk, racial and ethnic minority populations: Toward promoting health equity

et al. 2023

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Continuous glucose monitors (CGMs) have become an important tool to aid self-management of blood glucose for many patients with diabetes in the U.S., and the benefits of CGM use are well-documented. However, disparities in CGM use exist, with lower use in certain marginalized racial and ethnic groups. CGM may be an important and underutilized tool to help reduce inequities. Evidence supporting the use of CGMs as a part of virtual care is discussed, with an emphasis on designing virtual diabetes care programs to promote health equity. Recommendations for clinical practice and research are presented. In clinical practice, CGM should be an option for all people with diabetes who qualify based on clinical practice guidelines, regardless of race, ethnicity, or other individual characteristics. Future research should characterize the use of, benefit from, and preferences for CGM among individuals from racial and ethnic groups to guide interventions at the health system, clinic, provider, and patient levels to promote equitable, evidence-based, and guideline-directed CGM use in marginalized racial and ethnic groups with diabetes.

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“…We hypothesized that while beneficiaries of both provider types would increase the amount of administrative claims after coverage started, 11 beneficiaries receiving care from an endocrinologist would be more likely to have administrative claims for CGM supplies 12 . Insurance coverage and costs for CGM supplies is a major concern of both providers and patients and a barrier to uptake 13–15 . A benefit to using data on one type of insurance (WVM) is that our results cannot be driven by any provider bias in technology recommendations based on insurance type 16 .…”

mentioning

confidence: 99%

Association of Continuous Glucose Monitor Receipt and Diabetes Care Provider Type

Gaulke,

Giordano,

Grossman

2023

Medical Care

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Objective: To compare the prevalence of West Virginia Medicaid (WVM) beneficiaries with type 1 diabetes (T1D) with a WVM administrative claim for continuous glucose monitoring (CGM) supplies by whether they received medical care from a board-certified endocrinologist. Methods: 1494 WVM beneficiaries aged 20–64 with T1D were retrospectively followed from May 2018 to April 2020. The sample consisted of 2 groups: those receiving medical care from board-certified endocrinologists and those receiving medical care from other providers. CGM prevalence is compared before and after WVM started providing insurance coverage for beneficiaries with T1D to use CGM systems in May 2019 using linear regression with and without adjustments for patient characteristics. Results: Thirty-five percent of beneficiaries received care from a board-certified endocrinologist at any point during the sample period. Post–May 2019, the prevalence of WVM administrative claims for CGM supplies was significantly higher among beneficiaries receiving care from an endocrinologist compared with other providers. Conclusions: Receiving diabetes care from a board-certified endocrinologist is positively associated with having administrative claims for CGM supplies.

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Delays in Continuous Glucose Monitoring Device Initiation: A Single Center Experience and a Call to Change

Cited by 11 publications

References 11 publications

DiabetesWise: An innovative approach to promoting diabetes device awareness

DiabetesWise: An innovative approach to promoting diabetes device awareness

Continuous glucose monitors and virtual care in high-risk, racial and ethnic minority populations: Toward promoting health equity

Association of Continuous Glucose Monitor Receipt and Diabetes Care Provider Type

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