Introducing CGM at Type 1 Diabetes Diagnosis
Introducing CGM at Type 1 Diabetes Diagnosis
Diabetes technology is changing and has quickly become an integral part of diabetes care and
 management. The study team plans to study the effects of introducing technology to newly
 diagnosed type 1 diabetes patients. The investigators hypothesize that early access to
 continuous glucose monitoring (CGM) technology will potentially improve satisfaction scores,
 hemoglobin A1c, glycemic control, reduce hypoglycemia, and ease the burden of disease when
 compared to new onset patients who receive standard of care access to CGM.
Abstract: Diabetes technology is changing and has quickly become an integral part of diabetes
 care and management. Typically, patients will need to wait months due to paperwork,
 insurance, and logistical issues before utilizing these technologies. With this project, the
 investigators plan to study the effects of introducing technology to newly diagnosed type 1
 diabetes patients. It is hypothesized that early access to flash continuous glucose
 monitoring (CGM) technology will improve scores in diabetes's measures. The primary outcome
 with be the parent version of the Diabetes Treatment Satisfaction Questionnaire (DTSQ).
 Secondary outcomes will include other diabetes measures such as DTSQ teen version,
 Hypoglycemia Fear Survey (HFS)- Parent and child version, Diabetes Distress Survey
 (DDS)-parent version, PedsQL- parent and child versions. The study team will also look at
 other diabetes outcomes including A1c, time in range, and reduction in hypoglycemia.

 Background: Type 1 diabetes is a complex disease requiring newly diagnosed pediatric patients
 and families to learn how to check blood glucoses, inject insulin, count carbohydrates, treat
 hypoglycemia/hyperglycemia, and perform many other complex tasks, all within the first few
 days after diagnosis.

 Continuous glucose monitors (CGMs) and flash glucose monitors have emerged as important
 diabetes technologies towards providing improved care and easing the burden of disease. These
 technologies are most typically introduced to families in the outpatient setting 2-3 months
 following diagnosis due to logistical issues related to insurance coverage.

 Barriers to access include requirements for insurance prior authorization, lack of immediate
 availability at local pharmacies, need for patient training, and the historical bias towards
 requiring finger stick glucose monitoring as the basis for diabetes management. Despite these
 barriers, the data supports the observation that CGM technology provides for better
 understanding of diabetes, improved quality of life for parents and children, reduced
 frequency of hypoglycemia, and improved A1c.

 This project will potentially show the feasibility of introducing these technologies at
 diagnosis. New onset type 1 diabetes patients will be randomized to receive either a
 Freestyle Libre flash glucose monitoring system immediately at diagnosis or to delayed use of
 CGM (standard of care).
Inclusion Criteria:

 -  Diagnosis of type 1 diabetes mellitus

 Exclusion Criteria:

 -  No diagnosis of type 1 diabetes mellitus