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REDUCTION IN DIABETES-RELATED HOSPITALIZATION RATES AFTER REAL-TIME CONTINUOUS GLUCOSE MONITOR (RTCGM) INITIATION
Abstract
Background and Aims
Inadequate glycemic control in patients with diabetes can result in diabetes-related hospitalizations. RtCGM helps with glycemic management by providing current glucose level and glucose trends. This study evaluated change in diabetes-related hospitalizations before and after rtCGM initiation.
Methods
A retrospective analysis of administrative claims data from the Optum Clinformatics® Database was conducted. CGM naïve patients with type 1 (T1D) and type 2 diabetes (T2D) initiated rtCGM (Dexcom G6) between 8/1/2018 and 3/31/2020 (index date = earliest observed pharmacy claim). Continuous health plan enrollment of 12-months pre, and 12-months post index date and ≥1 sensor pharmacy claim after index was required for study inclusion. Individuals with evidence of pregnancy were excluded. Diabetes-related ER and inpatient visits were assessed during the 12-months pre- and 12-months post-index periods and expressed as changes in number of visits and days of hospital stay.
Results
A total of 806 T1D (average age= 38.8 (sd=14.2) years, 45% female) and 337 T2D (average age= 52.6(sd=10.5) years, 46% female) rtCGM users on intensive insulin therapy met inclusion criteria. Statistically significant reductions were observed after rtCGM initiation in diabetes-related inpatient stays (T1D= -54%, p<0.001; T2D= -48%, p<0.001). RtCGM initiation resulted in reduced average length of stay (T1D= -0.39 days, p=0.01; T2D= -0.88 days, p=0.02). However, reductions in diabetes-related ER visits did not reach statistical significance (T1D= -29%, p=0.07; T2D= -15%, p=0.52).
Conclusions
These findings provide real-world evidence rtCGM was associated with reduced diabetes-related hospitalizations. Improved access to rtCGM may help more T1D and T2D patients avoid serious glycemic excursions that result in hospitalizations.