A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health reveals significant improvements in blood sugar management among individuals with type 1 diabetes over the past 15 years, driven by the widespread adoption of continuous glucose monitoring (CGM) and insulin delivery devices.
The study analyzed nearly 200,000 de-identified electronic health records from 2009 to 2023, tracking the use of CGM and insulin pumps alongside blood sugar control (measured by HbA1c levels). Key findings include:
- Improved Glucose Control: The percentage of children under 18 with optimal HbA1c levels (<7%) rose from 7% (2009–2011) to 19% (2021–2023)—a 171% increase. Among adults, optimal control increased from 21% to 28% (33% increase).
- Surge in Technology Use:
- CGM adoption skyrocketed from 4% to 82% in youths and 5% to 57% in adults.
- Insulin pump use rose from 16% to 50% in youths and 11% to 29% in adults.
- Concurrent use of both devices jumped from 1% to 47% in youths and 1% to 22% in adults.
Despite progress, disparities persist, with non-Hispanic white patients and those with commercial insurance showing higher rates of technology adoption and glucose control. For example, only 12% of non-Hispanic Black youths achieved optimal control in 2021–2023, compared to 21% of non-Hispanic white youths.
The researchers emphasize the need for better access to diabetes technologies to reduce these gaps. While the advancements are promising, most patients still do not meet optimal glucose targets, indicating room for further improvement.
Published in JAMA Network Open (August 11), the study highlights how modern diabetes technologies have transformed care, with future research planned to examine long-term complications like heart and kidney disease in type 1 diabetes patients.
Key Takeaways:
- Technology Drives Improvement: CGM and insulin pumps have significantly enhanced blood sugar management.
- Disparities Remain: Racial and insurance-based gaps in access and outcomes need addressing.
- Ongoing Challenges: Most patients still lack optimal control, calling for further innovation and policy changes.