Health Care Costs, Hospital Admissions, and Glycemic Control Using a Standalone, Real-Time, Continuous Glucose Monitoring System in Commercially Insured Patients With Type 1 Diabetes

Gill, Max; Zhu, Cyrus; Shah, Mona; Chhabra, Harmeet

doi:10.1177/1932296818777265

Cited by 16 publications

(15 citation statements)

References 28 publications

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“…30 Similarly, economic benefits of CGM therapy have been reported with increased frequency, with decrease in total health care costs and hospital admissions. 31,32…”

Section: Resultsmentioning

confidence: 99%

Continuous Glucose Monitoring Integration in Clinical Practice: A Stepped Guide to Data Review and Interpretation

Webb

2018

J Diabetes Sci Technol

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Background: The advent of continuous glucose monitoring (CGM) technology has transformed the approach to diabetes care. Multiple CGM systems are commercially available and increased accuracy has allowed development of hybrid and automated insulin delivery systems. Evidence of CGM clinical benefits has also increased exponentially in the last decade. Methods: Literature search, review of professional guidelines, and consensus statements were used to guide the preparation of this article. The clinical benefits of both professional and personal CGM in clinical practice as well as barriers to wider adotpion were explored. A stepped approach to review and interpretation of CGM data is suggested for use in the clinician’s office regardless of the software used. Results: Although increasing, the use of CGM in patients with diabetes is still not widespread; multiple barriers are still in place, despite the approval of CGM systems for patients above the age of 2 years old, the extension of coverage for Medicare beneficiaries and the integration of CGM with multiple insulin pump systems. Integration of CGM technology in clinical practice presents various challenges, from concerns relative to time constraints during office visits to lack of systematic approach to interpretation of the data. Conclusions: Understanding the usefulness of personal and professional CGM, appropriate patient selection as well as patient and provider training are crucial for the expansion of CGM therapy use in clinical practice. Utilizing the proposed stepped approach to CGM review and interpretation may allow wider adoption of CGM with more effective and efficient office visits.

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“…30 Similarly, economic benefits of CGM therapy have been reported with increased frequency, with decrease in total health care costs and hospital admissions. 31,32…”

Section: Resultsmentioning

confidence: 99%

Continuous Glucose Monitoring Integration in Clinical Practice: A Stepped Guide to Data Review and Interpretation

Webb

2018

J Diabetes Sci Technol

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“…14 Both randomized and observational studies of early 15-18 and more recent 19-22 standalone real-time CGM (RT-CGM) systems have demonstrated improved glycemic control (ie, reduced glucose variability, hypoglycemia, severe hypoglycemia, fear of hypoglycemia, and even impaired hypoglycemia awareness) compared to conventional self-monitoring of blood glucose (SMBG) measurements alone or blinded CGM use with multiple daily injections (MDIs) therapy. Improved quality of life and psychological wellbeing, 23,24 as well as cost-effectiveness, 25,26 have been reported with standalone RT-CGM system use. A similar trend of glycemic improvement with RT-CGM has been observed for individuals with type 2 diabetes (T2D) treated with MDI therapy or oral hypoglycemic agents (OHAs) versus SMBG alone with MDI therapy or OHA.…”

Section: Introductionmentioning

confidence: 99%

Improved Real-World Glycemic Control With Continuous Glucose Monitoring System Predictive Alerts

Abraham

Arunachalam

Zhong

et al. 2019

J Diabetes Sci Technol

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Background: Most standalone real-time continuous glucose monitoring (RT-CGM) systems provide predictive low and high sensor glucose (SG) threshold alerts. The durations and risk of low and high SG excursions following Guardian™ Connect CGM system predictive threshold alerts were evaluated. Methods: Continuous glucose monitoring system data uploaded between January 2, 2017 and May 22, 2018 by 3133 individuals using multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) therapy were deidentified and retrospectively analyzed. Glucose excursions were defined as SG values that went beyond a preset low or high SG threshold for ≥15 minutes. For a control group, thresholds were based on the median of the low SG threshold limit (70 mg/dL) and the high SG threshold limit (210 mg/dL) preset by all system users. During periods when alerts were not enabled, timestamps were identified when a predictive alert would have been triggered. The time before low horizon was 17.5 minutes and the time before high horizon was 15 minutes, of all users who enabled alerts. Excursions occurring after a low SG or high SG predictive alert were segmented into prevented, ≤20, 20-60, and >60 minutes. Results: Excursions were prevented after 59% and 39% of low and high SG predictive alerts, respectively. The risk of a low or high excursion occurring was 1.9 ( P < 0.001, 95% CI, 1.88-1.93) and 3.3 ( P < 0.001, 95% CI, 3.20-3.30) times greater, respectively, when alerts were not enabled. Conclusions: The predictive alerts of the RT-CGM system under study can help individuals living with diabetes prevent some real-world low and high SG excursions. This can be especially important for those unable to reach or maintain glycemic control with basic RT-CGM or CSII therapy.

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“…It could even lead to continuous glucose monitoring (CGM), making it possible to detect almost instantaneously any glycemia change, and allow the individual or other devices to perform the right correction at the moment, noticeably enhancing the treatment of diabetes [2]. It would also reduce health costs, since they have been proven to be drastically lower when CGM is involved [3].…”

Section: Introductionmentioning

confidence: 99%

Glucose Concentration Measurement in Human Blood Plasma Solutions with Microwave Sensors

Juan

Bronchalo

Potelon

et al. 2019

Sensors

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Three microwave sensors are used to track the glucose level of different human blood plasma solutions. In this paper, the sensors are evaluated as glucose trackers in a context close to real human blood. Different plasma solutions sets were prepared from a human blood sample at several added glucose concentrations up to 10 wt%, adding also ascorbic acid and lactic acid at different concentrations. The experimental results for the different sensors/solutions combinations are presented in this work. The sensors show good performance and linearity as glucose level retrievers, although the sensitivities change as the rest of components vary. Different sensor behaviors depending upon the concentrations of glucose and other components are identified and characterized. The results obtained in terms of sensitivity are coherent with previous works, highlighting the contribution of glucose to the dielectric losses of the solution. The results are also consistent with the frequency evolution of the electromagnetic signature of glucose found in the literature, and are helpful for selecting frequency bands for sensing purposes and envisioning future approaches to the challenging measurement in real biological contexts. Discussion of the implications of the results and guidelines for further research and development of more accurate sensors is offered.

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Health Care Costs, Hospital Admissions, and Glycemic Control Using a Standalone, Real-Time, Continuous Glucose Monitoring System in Commercially Insured Patients With Type 1 Diabetes

Abstract: Use of rtCGM by patients with T1DM is associated with lower health care costs, fewer hospital admissions, and better glycemic control.

Cited by 16 publications

References 28 publications

Continuous Glucose Monitoring Integration in Clinical Practice: A Stepped Guide to Data Review and Interpretation

Continuous Glucose Monitoring Integration in Clinical Practice: A Stepped Guide to Data Review and Interpretation

Improved Real-World Glycemic Control With Continuous Glucose Monitoring System Predictive Alerts

Glucose Concentration Measurement in Human Blood Plasma Solutions with Microwave Sensors

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