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CGM lends long-term cost savings in type 1 diabetes
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For adults with type 1 diabetes using multiple insulin injections, continuous glucose monitoring is a cost-effective alternative to self-monitoring blood glucose, according to findings published in Diabetes Care.
“The [CGM] device does increase health care costs, but this is offset by the prevention of future costly complications,” Elbert S. Huang, MD, MPH, FACP, professor of medicine, director of the Center for Chronic Disease Research and Policy, and associate director of the Chicago Center for Diabetes Translation Research at the University of Chicago, told Endocrine Today.
In the 6-month DIAMOND trial, researchers randomly assigned patients with type 1 diabetes and HbA1c levels of at least 7.5% to a CGM group (n = 105; 45% women; 90% white; mean age, 45.7 years) or a control group (n = 53; 43% women; 94% white; mean age, 51.4 years). All patients provided information about their health-related quality of life, utilization of health services outside the study, medications, test-strip use, work productivity if employed, and daily hours spent on self-management diabetes care at baseline and 6 months. Researchers conducted an analysis on the cost-effectiveness of CGM both within the trial, using observed data, and over a lifetime, using a modified Sheffield type 1 diabetes policy model.
At 6 months, the within-trial cost-effectiveness results showed an average total cost of $11,032 for the CGM group and an average total cost of $7,236 for the control group (P < .01). The difference in total costs stemmed predominately from the CGM device cost of $2,554, according to the researchers. Within the trial, HbA1c levels decreased 1% for the CGM group vs. 0.4% for the control group (P < .01). Combined with decreases in daily test-strip use and nonsevere hypoglycemic events in the CGM group, researchers concluded that these benefits would be heightened over a lifetime with an estimated incremental cost-effectiveness ratio of $98,108 per quality-adjusted life-year.
In addition, the results of the lifetime analysis suggest that compared with the control group, CGM will more greatly reduce the incidence rates of typical type 1 diabetes complications, including blindness (1.9% vs. 1.8%), end-stage renal disease (11.7% vs. 10.1%), amputations (8.1% vs. 7.1%), myocardial infarction (37.8% vs. 37%), stroke (7.2% vs. 7%) and heart failure (11.1% vs. 10.7%). Life expectancy also was extended by 0.72 years with CGM use, according to the analysis.
“CGM has multiple clinical benefits including a reduction in long-term glucose levels while at the same time reducing the risk of hypoglycemia,” Huang said. “That combination of clinical benefits was achieved without adding any additional medications. CGM has the potential to significantly reduce long-term complications while improving short-term quality of life.” – by Melissa J. Webb
For more information:
Elbert S. Huang, MD, MPH, FACP, can be reached at ehuang@medicine.bsd.uchicago.edu.
Disclosures: The study was funded by a grant from Dexcom. The authors report no other relevant financial disclosures.
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