<b>Objective:</b> Continuous glucose monitoring (CGM) is increasingly
used in type 1 diabetes management however funding models vary. This study
determined the uptake rate and glycaemic outcomes following a change in
national health policy to introduce universal subsidised CGM funding for people
with type 1 diabetes aged < 21 years.
<p><b>Research Design and Methods:</b> Analysis of
longitudinal data from 12 months prior to subsidy until 24 months after.
Measures and outcomes included age, diabetes duration, HbA1c, episodes of
diabetic ketoacidosis and severe hypoglycaemia, insulin regimen, CGM uptake and
percentage CGM use. Two data sources were used: the Australasian Diabetes
Database Network (ADDN) registry (a prospective diabetes database) and the
National Diabetes Supply Scheme (NDSS) registry that includes almost all
individuals with type 1 diabetes nationally.</p>
<p><b>Results:</b> CGM uptake increased from 5% pre-subsidy to 79% after two
years. After CGM introduction, the odds ratio (OR) of achieving the HbA1c
target of <7.0% improved at 12 months (OR 2.5, p<0.001) and was
maintained at 24 months (OR 2.3, p<0.001). The OR for suboptimal glycaemic
control (HbA1c ≥ 9.0%) decreased to 0.34 (p<0.001) at 24 months. Of CGM
users, 65% used CGM >75% of time: these had a lower HbA1c at 24 months
compared to those with usage <25% (7.8±1.3% vs 8.6±1.8%, respectively,
p<0.001). DKA was also reduced in this group (IRR 0.49, 95% CI
0.33-0.74, p<0.001).</p>
<b>Conclusions:</b> <a></a>Following
national subsidy, CGM use was high and associated with sustained improvement in
glycaemic control. This information will inform economic analyses and future
policy and serve as a model of evaluation diabetes technologies.