Implementation of Intermittently Scanned Continuous Glucose Monitoring and Changes in Hospitalizations and Health Care Costs in Insulin-Treated Type 2 Diabetes
Authors' conclusion
In this real-world study, implementation of isCGM among insulin-treated adults with T2D was associated with substantial reductions in acute diabetes-related hospitalizations, shorter hospital stays, lower health care costs, and changes in cardiovascular hospitalization trends.
Study context
- Population
- Adults with T2D on MDI who initiated publicly funded isCGM between April 2022 and December 2023
- Participants
- 15,413 adults
- Exposure
- After vs before isCGM initiation
- Outcome
- Hospitalizations for acute diabetes-related complications (DKA, HHS, simple hyperglycemia, hypoglycemia)
Methodological detailsinterrupted time series analyses, Poisson models, before-after comparison, Mean follow-up 22.5 ± 4.6 months before and 19.1 ± 4.4 months after isCGM initiation
- Interrupted time series analyses
- Poisson models
- Before-after comparison
- Mean follow-up 22.5 ± 4.6 months before and 19.1 ± 4.4 months after isCGM initiation
Main finding
As reported in the abstract
Diabetes-related hospitalization rate decreased (before to after isCGM initiation)
74.6 to 27.5 per 10,000 person-years
RR after vs before isCGM initiation
RR 0.37
95% CI 0.28–0.49
Observational data: associations, not effects.
Further findings
Cardiovascular hospitalizations (MI, stroke, major lower-extremity amputation)
- Cardiovascular hospitalization rates remained stable (before vs after isCGM initiation)
- 228.8 vs. 215.8 per 10,000 person-years
- RR after vs before isCGM initiation
- RR 0.94 [0.84-1.06]
- Interrupted time series: change in cardiovascular admission rates after isCGM initiation relative to the preintervention trend
HbA1c
- Mean HbA1c decreased (before to after isCGM initiation)
- 8.09 to 7.65%
- Mean difference
- −0.44 [95% CI −0.47 to −0.42]
Length of stay
- Median LOS decreased (before to after isCGM initiation)
- 4 (interquartile range 5) to 3 (4) days
Inpatient health care costs
- Total inpatient costs decreased by
- $3,806,776.90
- Decrease per 10,000 person-years
- -$955,186.70
Original publication
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