Bergenstal Richard M, Kerr Matthew S D, Roberts Gregory J, Souto Diana, Nabutovsky Yelena, Hirsch Irl B
International Diabetes Center, Park Nicollet and HealthPartners, Minneapolis, MN, USA.
Abbott, Sylmar, CA, USA.
J Endocr Soc. 2021 Feb 2;5(4):bvab013. doi: 10.1210/jendso/bvab013. eCollection 2021 Apr 1.
Suboptimal glycemic control among individuals with diabetes is a leading cause of hospitalizations and emergency department utilization. Use of flash continuous glucose monitoring (flash CGM) improves glycemic control in type 1 and type 2 diabetes, which may result in lower risk for acute and chronic complications that require emergency services and/or hospitalizations.
In this retrospective, real-world study, we analyzed IBM MarketScan Commercial Claims and Medicare Supplemental databases to assess the impact of flash CGM on diabetes-related events and hospitalizations in a cohort of 2463 individuals with type 2 diabetes who were on short- or rapid-acting insulin therapy. Outcomes were changes in acute diabetes-related events (ADE) and all-cause inpatient hospitalizations (ACH), occurring during the first 6 months after acquiring the flash CGM system compared with event rates during the 6 months prior to system acquisition. ICD-10 codes were used to identify ADE for hypoglycemia, hypoglycemic coma, hyperglycemia, diabetic ketoacidosis, and hyperosmolarity.
ADE rates decreased from 0.180 to 0.072 events/patient-year (hazard ratio [HR]: 0.39 [0.30, 0.51]; < 0.001) and ACH rates decreased from 0.420 to 0.283 events/patient-year (HR: 0.68 [0.59 0.78]; < 0.001). ADE reduction occurred regardless of age or gender.
Acquisition of the flash CGM system was associated with reductions in ADE and ACH. These findings provide support for the use of flash CGM in type 2 diabetes patients treated with short- or rapid-acting insulin therapy to improve clinical outcomes and potentially reduce costs.
糖尿病患者血糖控制不佳是住院和急诊就诊的主要原因。使用闪光连续血糖监测（Flash CGM）可改善1型和2型糖尿病患者的血糖控制，这可能会降低需要急诊服务和/或住院治疗的急慢性并发症风险。
在这项回顾性的真实世界研究中，我们分析了IBM MarketScan商业索赔和医疗保险补充数据库，以评估Flash CGM对2463例接受短效或速效胰岛素治疗的2型糖尿病患者队列中糖尿病相关事件和住院情况的影响。结局指标为与获取Flash CGM系统后前6个月内发生的急性糖尿病相关事件（ADE）和全因住院（ACH）的变化，并与系统获取前6个月的事件发生率进行比较。使用国际疾病分类第十版（ICD-10）编码来识别低血糖、低血糖昏迷、高血糖、糖尿病酮症酸中毒和高渗性等ADE。
ADE发生率从0.180次/患者年降至0.072次/患者年（风险比[HR]：0.39[0.30，0.51]；P<0.001），ACH发生率从0.420次/患者年降至0.283次/患者年（HR：0.68[0.59，0.78]；P<0.001）。无论年龄或性别，ADE均有所减少。
获取Flash CGM系统与ADE和ACH的减少相关。这些发现为在接受短效或速效胰岛素治疗的2型糖尿病患者中使用Flash CGM以改善临床结局并可能降低成本提供了支持。
