Abstract
BACKGROUND: Those caring for children and adolescents with diabetes often use glucose concentration and trending information in management decisions. Some continuous glucose monitoring (CGM) systems offer real-time sharing and monitoring capabilities through mobile apps carried by the person with diabetes and the caregiver(s), respectively. Few large studies have explored real-world associations between sharing and following, CGM utilization, and glycemic outcomes. METHODS: We performed a retrospective evaluation of device usage and glycemic control in 15,000 youth ranging in age from 2 to 18 years by analyzing anonymized data that had been uploaded with a mobile app that provides optional sharing. The presence or absence of a real-time monitor (a "Follower") was established on 15 June 2018. Each day with ≥ 1 uploaded glucose values was counted as a day of device usage. Between-group glucose comparisons were made with two-sided Welch's t tests. RESULTS: Overall, 94.8% of the population used the sharing feature and had at least one Follower. The mean numbers of Followers for patients aged 2-5, 6-12, and 13-18 years were 2.8, 2.8, and 2.4, respectively. In all three age categories, the presence of at least one Follower was associated with lower mean glucose values, more glucose values in the 70- to 180-mg/dL range, correspondingly fewer glucose values representing hypoglycemia and hyperglycemia, and significantly more device utilization. CONCLUSION: Real-time sharing and following of CGM data are associated with improved device utilization and glycemic parameters. The observed association suggests either more timely interventions or higher levels of engagement among the caregivers or the youth with diabetes. FUNDING: Dexcom, Inc.