Background: Continuous glucose monitoring (CGM) improves glycemic control for youth with type 1 diabetes (T1D) . Despite these benefits, less than half of youth with T1D use CGM. Objective: To determine if trial CGM use (10-days) increases CGM uptake and is associated with improved glycemic control among minority youth and youth with poorly controlled T1D. We also examined barriers to CGM use. Methods: This prospective study was conducted at an academic Pediatric Diabetes Center. Youth with T1D for more than 3 months, with no previous CGM usage, or no CGM usage in the last year were enrolled. Diabetes staff placed CGM at the point of care (POC) and provided CGM education. Barriers to prior CGM use, hemoglobin A1c (HbA1c) , and demographic information were recorded. Participants received 5 and 10-day follow up calls from the diabetes team to review glycemic trends. At 3 months, participants' use of CGM and HbA1c were recorded. Results: Youth with T1D (n=22) were enrolled (13 first time CGM users, 9 past users) , mean age 14.1years (SD 3.1) , 41% non-Hispanic black, 68% female, mean diabetes duration 6.3 ± 4.4years, and baseline mean HbA1c of 10.8%. Patient-cited barriers to prior CGM use included technical difficulties (n=5) , unawareness of CGM (n=4) , difficulty obtaining CGM (n=4) , general apprehension (n=3) , not wanting devices (n=3) , and pain, fear of needles, and new diabetes diagnosis (n=1 each) . Of participants, 20 completed some follow-up, and 18/20 (90%) cited wanting to use CGM long-term. Of 13 participants who completed 3 and/or 6-month follow-up visits, only 9 were actively using CGM. Further barriers to use included insurance issues (n=2) and CGM falling off (n=1) . There was no change in mean HbA1c from baseline to follow-up (10.8 ±2.4% vs. 10.3 ±2.3%, p=0.46) . Conclusion: There are many barriers to CGM uptake in youth. Providing a trial use of CGM at the POC may increase uptake of CGM use in at-risk diabetes populations, but further investigation of additional barriers that impact long-term adherence to CGM is needed. Disclosure T.L.Lin: None. J.A.Manfredo: None. N.Illesca: None. K.Abiola: None. N.Hwang: None. M.Seel: None. E.A.Brown: None. R.M.Wolf: Consultant; NEMA Research, Research Support; Dexcom, Inc. Funding Johns Hopkins Children's Center Innovation Award, and Dexcom

Background: Continuous glucose monitor (CGM) is a widely accepted tool for managing glycemia in youth with type 1 diabetes (T1D) and adults with type 2 diabetes (T2D) ; however, studies exploring its use in T2D in youth are limited. Objective: Determine if a day trial use of CGM in youth with T2D improves short term and long term glycemic control as measured by time in range (TIR = percentage of time blood glucose is 70-180 mg/dL) , and 3 mo hemoglobin A1c (HbA1c) , respectively. Methods: Youth with T2D for more than 3 mos, on insulin therapy, with no prior CGM use were enrolled. Diabetes staff placed the CGM at the point of care and provided standardized education. At initial visit, HbA1c and demographic information were recorded. Participants received a 5 day and day follow up (FU) phone call from diabetes staff to review glucose and TIR data, with counseling and dose adjustments as needed. At 3 mos, HbA1c was recorded. We compared 5 day TIR and day TIR, and baseline and 3 mo HbA1c via paired t-test. Results: Youth with T2D (n=35) enrolled had mean age of 15.9 y (SD 1.9 y) , 63% female, 83% black, and average diabetes duration of 1.8 y (SD 1.6 y) . A majority had household income <$50K (63%) and parental education level of HS degree or less (68%) . Average 5 day TIR 48% was similar to day TIR 51% (p=0.28) . There was no change in HbA1c after 3 months (10.3% v 11.1%, p=0.39) . Only 18 participants completed the full day CGM use; those that did not cited device connection issues (3) , device fell off early (8) , device removed early due to irritation (3) or lost to FU (3) . Of the 18 youth who completed day CGM use and nursing FU calls, 78% wanted to use a CGM long term. Conclusion: Although a trial CGM use over days did not impact short term or long term glycemic control in youth with T2D, most participants who completed the full days wanted to continue using CGM. Issues with device connectivity and adhesion were barriers to consistent device use. Future larger studies with longer use of CGM may help clarify the potential impact of CGM in youth with T2D. Disclosure J.A.Manfredo: None. R.M.Wolf: Consultant; NEMA Research, Research Support; Dexcom, Inc. T.L.Lin: None. R.Gupta: Consultant; Cabaletta Bio. K.Abiola: None. M.West: None. K.Busin: None. J.Tracey: None. E.A.Brown: None. S.N.Magge: None. Funding Johns Hopkins Childrens Center Innovation Award Dexcom (investigator-initiated support)