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Short-term CGM use may reduce type 2 diabetes treatment costs

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October 26, 2017

Adults with type 2 diabetes using a professional continuous glucose monitor experienced a reduction in HbA1c as well as lower diabetes treatment costs after 1 year compared with those who did not use the monitoring, study data show.

Professional CGM consists of short-term monitoring (typically 3 to 7 days) to gather data for assessment by a health care provider who will use them to design a treatment regimen, according to study background.

Joseph A. Sierra, of Medtronic Diabetes Inc. in Northridge, California, and colleagues evaluated data from 2009 to 2014 from the Clinformatics Data Mart on 16,647 people with type 2 diabetes using professional CGM as well as 670,812 people with type 2 diabetes not using CGM to determine expenditures and clinical outcomes associated with use of the technology. Researchers evaluated data 1 year before and 1 year after the use of professional CGM.

Participants using professional CGM were identified by CPT codes 95250 and 95251, which represent initial placement of a professional CGM device on a patient and a health care provider’s subsequent interpretation of data from the device. The researchers used a generalized linear model to identify clinical and economic outcomes 1 year before and 1 year after use of the device.

Among the entire cohort, baseline total health care costs per patient were higher for participants using professional CGM (mean, $23,021 per patient) compared with participants who did not (mean, $21,502), and costs increased to $26,525 and $23,736, respectively, per patient per year after 1 year for a nonsignificant “difference-in-difference” growth of total cost of $1,270 per patient per year for professional CGM users.

Although costs were higher for professional CGM users, their HbA1c reductions were also greater compared with the group without CGM (“difference-in-difference,” –0.44% favoring professional CGM; P < .001).

In a subset of 1,652 participants who experienced a change in their diabetes treatment regimen costs, CGM users had higher costs in the baseline period compared with non-CGM users ($23,490 vs. $22,106); however, after 1 year, costs were higher for non-CGM users than CGM users ($28,637 vs. $26,694) for a reduction of $3,327 in costs for the CGM group (P = .0023).

“Data from this study is compelling and adds to the growing body of clinical and now economic evidence demonstrating the significant benefits of professional CGM in patients with type 2 diabetes,” study researcher Francine Kaufman, MD, chief medical officer of the Diabetes Group at Medtronic, said in a press release. “As suggested in the American Association of Clinical Endocrinologists Consensus Statement on the use of professional CGM, it is a powerful tool to help get patients to their HbA1c target and reduce glycemic variability. These results also suggest that professional CGM can help reduce the escalating costs of type 2 diabetes.” – by Amber Cox

Disclosures: Sierra and Kaufman are employees of Medtronic. Please see the study for all other authors’ relevant financial disclosures.

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Gary Scheiner
Perspective

These types of studies fail to control for the skills/personality of the patient and the clinician. After all, those who provide/analyze professional CGM are likely to do a better job of managing all their patients compared with those who do not. Patients who agree to use professional CGM are more likely to be engaged in their care and utilize new technologies than those who do not. That said, even if the results had shown no improvements, I believe that professional CGM offers exceptional return on investment when implemented by providers who truly understand how to interpret the data, devise appropriate therapy adjustments, and coach their patients on how to implement their recommendations. Without these skills, technologies such as professional CGM have little chance to improve patient outcomes. Parallels can be drawn to use of self-monitoring of blood glucose and insulin pumps in patients with type 2 diabetes.

Gary Scheiner MS, CDE

Owner, Clinical Director
Integrated Diabetes Services
Wynnewood, PA

Disclosure: Scheiner reports no relevant financial disclosures.