Increasing Use of Continuous Glucose Monitors in Publicly-insured Youth With Type 1 Diabetes

Improving Adherence to Continuous Glucose Monitors in Publicly-insured Youth With Type 1 Diabetes

To use an enhanced continuous glucose monitor (CGM) experience, including an automated CGM-electronic health record (EHR) data integration system, proactive interventions, and gamification techniques, to increase CGM use among publicly-insured youth with type 1 diabetes (T1D).

The investigators will use an automated data integration system to monitor hours per week the CGM is worn and target interventions/troubleshooting techniques as needed. The investigators will use gamification techniques (i.e. ability to gain points and achieve small rewards) to help encourage CGM use and potentially improve glycemic control in this at-risk population.

Inclusion Criteria:

• type 1 diabetes for more than 6 months
• on insulin pump or multiple daily injections without plans to change modality in next 6 months
• insured by CCS or Medi-Cal
• receiving care at Lucile Packard Children's Hospital or Stanford Children's Health outpatient clinics
• English or Spanish-speaking

Exclusion Criteria:

• major illness or condition that may alter glucose control or ability to complete the study including pregnancy, cystic fibrosis, cancer, liver disease, history of transplant, or hemoglobinopathy
• current oral glucocorticoid use
• prior use of a CGM system
• hemoglobin A1C <7.5% or >12%
• no wireless internet access