- βCGM uptake surged from 5% to 79% when cost barriers were eliminated, proving access drives adoption
- βConsistent CGM users were 2.3x more likely to achieve target HbA1c under 7.0% (154 mg/dL) after 2 years
- βDiabetic ketoacidosis rates were cut nearly in half among patients who wore CGM more than 75% of the time
| Country | Australia |
| Journal | Diabetes care |
| Year | 2022 |
| Authors | Johnson, Holmes-Walker, Chee |
| PMID | 34872983 |
Australia's Free CGM Program Transformed Diabetes Control in Young Patients
A study from Australia offers a compelling real-world blueprint for what happens when young people with Type 1 diabetes are given free, universal access to continuous glucose monitors (CGM). Researchers at the Queensland Children's Hospital in Brisbane tracked outcomes for thousands of patients under age 21 β and the results were striking enough to deserve serious attention from American patients, families, and policymakers alike.
What the Researchers Did
When Australia's national government introduced a universal CGM subsidy for people under 21 with Type 1 diabetes, researchers saw a rare opportunity: study what happens to a whole population when cost barriers disappear overnight. They tracked data from 12 months before the subsidy launched through 24 months after, drawing from two major national registries covering nearly all young Australians with Type 1 diabetes.
The Numbers Tell a Powerful Story
Before the subsidy, only 5% of eligible young patients used CGM. After two years of free access, that number skyrocketed to 79% β a dramatic demonstration of how cost drives medical decisions even for life-changing technology.
But adoption alone isn't the headline. Blood sugar control improved significantly:
- Patients were 2.5 times more likely to achieve an HbA1c under 7.0% (equivalent to an estimated average blood glucose of approximately 154 mg/dL) at 12 months β a level considered excellent control.
- That improvement held steady at 24 months, with patients still 2.3 times more likely to hit that target.
- The odds of dangerously poor control β defined as HbA1c at or above 9.0% (roughly 212 mg/dL average) β dropped by 66%.
Among consistent CGM users (those wearing the device more than 75% of the time), average HbA1c was 7.8% (~178 mg/dL average) compared to 8.6% (~200 mg/dL) among those who wore it less than 25% of the time. Perhaps most critically, rates of diabetic ketoacidosis (DKA) β a potentially life-threatening emergency β were cut nearly in half among consistent users.
Why This Matters for US Patients
In the United States, CGM access remains uneven. While Medicare now covers CGM for many adults, coverage for children and young adults varies significantly by insurance plan, state Medicaid programs, and family income. The American Diabetes Association recommends CGM for most people with Type 1 diabetes, yet cost and coverage gaps continue to prevent consistent use for millions of American families.
This Australian study matters because it removes the guesswork: when cost is eliminated as a barrier, patients use CGM consistently, and consistent use saves lives and prevents hospitalizations. For US advocates, parents, and patients navigating insurance appeals or prior authorization battles, this population-level data provides powerful evidence that broad CGM access isn't just beneficial β it's transformative.
If your child or young adult family member has Type 1 diabetes and faces CGM access hurdles, ask your endocrinologist about manufacturer assistance programs, state-level advocacy resources, and how to document medical necessity for insurance purposes.
Study Citation
Johnson SR, Holmes-Walker DJ, Chee M, et al. Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study. Diabetes Care. 2022. PMID: 34872983. DOI: 10.2337/dc21-1666