Use of real-time CGM linked to lower health care costs in type 2 diabetes
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The use of real-time continuous glucose monitoring is associated with a decrease in diabetes-related health care costs, according to a brief report published in Diabetes Technology & Therapeutics.
“This study cohort mostly consisted of people with type 2 diabetes using insulin,” Gregory J. Norman, PhD, director of health economics and outcomes research at Dexcom, told Healio. “We don’t know from the data how patients were using the real-time CGM, but we can speculate that starting real-time CGM may have helped patients manage hypoglycemia and hyperglycemia, which could result in costly hospitalizations.”
Norman and colleagues conducted a retrospective analysis of health care costs for people with type 2 diabetes. Administrative claims from commercial and Medicare Advantage with Part D beneficiaries were obtained from the Optum Research Database. Adults with at least one pharmacy claim for a Dexcom real-time CGM device between October 2017 and February 2019 who were enrolled in a continuous health plan for at least 12 months before CGM initiation and remained enrolled at least 6 months after initiation were included. Health care utilization costs were determined from diagnosis and procedure codes for ambulatory care, ED visits, inpatient care and other medical care. Costs were considered to be diabetes-related if there was a diagnosis code for diabetes during the visit. The primary outcome was the difference in total diabetes-related medical costs before and after CGM initiation.
There were 571 adults with type 2 diabetes included in the analysis (mean age, 51.2 years; 46% women; 90% insulin treated). Mean diabetes-related health care costs were $1,680 per person per month before CGM use and $1,256 per person per month after initiation, for a decrease of $424 (95% CI; –816 to –31; P = .035). The overall decrease in diabetes-related medical costs came mostly from a $358 decrease in inpatient hospitalization costs from before CGM initiation to after (95% CI; –706 to –10; P = .044).
“This was a simple study looking at average monthly diabetes-related medical costs due to inpatient and outpatient care,” Norman said. “It wasn’t surprising that the largest cost reduction was seen for inpatient hospital stays, since hospital stays tend to be the highest cost medical service category for patients.”
Norman said more real-world studies and randomized controlled trials are needed to further explore the clinical effects of real-time CGM in people with type 2 diabetes.
“The evidence is accumulating for those using insulin for type 2 diabetes, but more studies are needed to determine if real-time CGM helps people earlier on, when they are only taking non-insulin antidiabetic medications prior to starting insulin,” Norman said. “We don’t know yet if real-time CGM can help slow the progression of type 2 diabetes. I would hypothesize real-time CGM can be a useful feedback tool to help people with type 2 diabetes not on insulin, and even those with prediabetes, understand how activity, diet and sleep affect their glycemic patterns.”
For more information:
Gregory J. Norman, PhD, can be reached at greg.norman@dexcom.com.
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