Continuous Glucose Monitor Metrics Are Associated with Emergency Department Visits and Hospitalizations for Hypoglycemia and Hyperglycemia, but Have Low Predictive Value
Authors' conclusion
Several CGM metrics were strongly associated with risk of dysglycemic events, and these can be used to identify higher risk patients. Also, patients who are not using their CGM device may be at elevated risk of adverse outcomes. However, no CGM metric or absence of CGM data had adequate discrimination to reliably provide actionable advance warning of an event and thus justify a rapid intervention.
Study context
- Population
- Insulin-treated diabetes patients at Kaiser Permanente sharing continuous glucose monitor (CGM) data with providers; dysglycemic events from emergency department (ED) and hospital records (2016–2021); metrics among patients using CGM >70% of the time
- Participants
- 3,626 CGM users
- Comparison
- CGM metrics (0-7 and 8-14 day lookbacks) and absence of CGM data vs risk of ED visit or hospitalization for dysglycemia
- Outcome
- ED visit or hospitalization for hypoglycemic or hyperglycemic (dysglycemic) events
Methodological detailstwo nested case-control studies, incidence density sampling, generalized estimating equations
- Two nested case-control studies
- Incidence density sampling
- Generalized estimating equations
Main finding
As reported in the abstract
- Hypoglycemic events
- 154 events in 108 patients
- Hyperglycemic events
- 335 events in 165 patients
- No CGM data during either lookback
- ≈25% of patients
- Odds of hypoglycemic event with no CGM data
- >2 ×
- Odds of hyperglycemic event with no CGM data
- 3-4 ×
Observational data: associations, not effects.
Original publication
Continuous Glucose Monitor Metrics Are Associated with Emergency Department Visits and Hospitalizations for Hypoglycemia and Hyperglycemia, but Have Low Predictive Value. Diabetes Technol Ther. Published 22 March 2024. doi:10.
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