Chicago—Continuous glucose monitors (CGMs) not only improve overall blood glucose control; they also reduce the risk of dangerous hypoglycemia, according to a new study on use of the technology.
The recent 6-month clinical trial compared the use of CGMs for adult patients with type 1 diabetes (T1D) with daily use of test strips. Researchers determined that the costs were within the range usually covered by insurance plans.
The study, published in Diabetes Care, also calculated the costs and health effects over the expected lifetime of patients, finding that CGMs actually increased quality of life by extending the amount of time patients enjoy relatively good health, free of complications.
“If you map out the lifetime of a patient, it’s impressive. The CGM adds years of life and years of quality life,” said senior author Elbert Huang, MD, Associate Director of the Chicago Center for Diabetes Translation Research at the University of Chicago. “While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs.”
For the randomized Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes (DIAMOND) trial, researchers focused on 158 patients with T1D with A1C of 7.5% or greater who relied on multiple daily injections of insulin, but not an insulin pump. Two-thirds of the group used CGMs, and the remaining one-third used the finger-prick method with test strips and a meter to check their blood sugar.
The longer-term simulation calculated quality-adjusted life years (QALYs) for each patient, with CGM projected to reduce the risk of complications from T1D and increase QALYs by 0.54, which translates to an additional 6 months of good health.
Within the 6-month trial, the CGM group had QALYs similar to the control group (0.462 ± 0.05 vs. 0.455 ± 0.06 years, P = .61), with the total 6-month costs being $11,032 (CGM) versus $7,236 (control). Results indicate that the CGM group experienced reductions in A1C (0.60 ± 0.74% difference in difference [DiD]), P < .01), the daily rate of nonsevere hypoglycemia events (0.07 DiD, P = .013), and daily test strip use (0.55 ± 1.5 DiD, P = .04) compared with the control group.
“For adults with T1D using multiple insulin injections and still experiencing suboptimal glycemic control, CGM is cost-effective at the willingness-to-pay threshold of $100,000 per QALY, with improved glucose control and reductions in non-severe hypoglycemia,” study authors concluded, adding that advances in CGM technology will also continue to lower costs as it further integrates with software and everyday digital devices such as smartphones.
“It hints at a future of chronic disease management that’s more cost effective and gives patients more control,” Huang said. “Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications. It empowers patients to manage their own health.”
The recent 6-month clinical trial compared the use of CGMs for adult patients with type 1 diabetes (T1D) with daily use of test strips. Researchers determined that the costs were within the range usually covered by insurance plans.
The study, published in Diabetes Care, also calculated the costs and health effects over the expected lifetime of patients, finding that CGMs actually increased quality of life by extending the amount of time patients enjoy relatively good health, free of complications.
“If you map out the lifetime of a patient, it’s impressive. The CGM adds years of life and years of quality life,” said senior author Elbert Huang, MD, Associate Director of the Chicago Center for Diabetes Translation Research at the University of Chicago. “While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs.”
For the randomized Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes (DIAMOND) trial, researchers focused on 158 patients with T1D with A1C of 7.5% or greater who relied on multiple daily injections of insulin, but not an insulin pump. Two-thirds of the group used CGMs, and the remaining one-third used the finger-prick method with test strips and a meter to check their blood sugar.
The longer-term simulation calculated quality-adjusted life years (QALYs) for each patient, with CGM projected to reduce the risk of complications from T1D and increase QALYs by 0.54, which translates to an additional 6 months of good health.
Within the 6-month trial, the CGM group had QALYs similar to the control group (0.462 ± 0.05 vs. 0.455 ± 0.06 years, P = .61), with the total 6-month costs being $11,032 (CGM) versus $7,236 (control). Results indicate that the CGM group experienced reductions in A1C (0.60 ± 0.74% difference in difference [DiD]), P < .01), the daily rate of nonsevere hypoglycemia events (0.07 DiD, P = .013), and daily test strip use (0.55 ± 1.5 DiD, P = .04) compared with the control group.
“For adults with T1D using multiple insulin injections and still experiencing suboptimal glycemic control, CGM is cost-effective at the willingness-to-pay threshold of $100,000 per QALY, with improved glucose control and reductions in non-severe hypoglycemia,” study authors concluded, adding that advances in CGM technology will also continue to lower costs as it further integrates with software and everyday digital devices such as smartphones.
“It hints at a future of chronic disease management that’s more cost effective and gives patients more control,” Huang said. “Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications. It empowers patients to manage their own health.”
