Impact of Continuous Glucose Monitor on Health Care Resource Utilization in Adults with Type 2 Diabetes Managed by Noninsulin Therapies

Abstract

Background:

Daily use of continuous glucose monitoring (CGM) has been shown to reduce diabetes-related events and associated costs in individuals with type 2 diabetes (T2D) regardless of their therapy. However, adoption of CGM among the large majority of T2D adults in the United States who are treated with noninsulin therapies has been limited.

Methods:

This retrospective database study assessed the effects of CGM acquisition on health care resource utilization (HCRU) in a large cohort of T2D adults treated with noninsulin, antidiabetes therapies. Inclusion criteria were T2D diagnosis, age ≥18 years, treated with noninsulin therapies, CGM-naive before CGM acquisition, and continuous medical/pharmacy insurance coverage during the 12-month preindex and postindex periods. The primary outcome measures were changes in all-cause hospitalizations (ACH), emergency department (ED) visits, acute diabetes complications, hyperglycemic events (HGE), and diabetic ketoacidosis (DKA) during the 12 months following CGM acquisition.

Results:

A total of 20,468 adults with T2D were included in this analysis. CGM acquisition was associated with significant reductions in event rates in the postindex period compared with the preindex period HCRU at 12 months: ACH (−25%), ED visits (−7%), HGE (−7%), DKA (−86%), and acute diabetes complications (−7%), all P < 0.0001. Similar reductions in events per person were also observed: ACH (−20.6%), ED visits (−7.2%), HGE (−6.2%), DKA (−63.0%), and acute diabetes complications (−6%), all P < 0.0001. Significant reductions were also seen in patients with cardiovascular disease. ACH and ED visits decreased by 35% and 12%, respectively; in those with liver disease by 25% and 13%; in those with renal disease, ACH decreased by 33%; and in those with hypertension, ACH and ED visits decreased by 26% and 7%, respectively. All reductions were statistically significant (P < 0.01).

Conclusions:

This analysis demonstrated an association between CGM acquisition and reductions in HCRU in adults with T2D treated with noninsulin therapies.