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住院患者持续血糖监测的成本效益

Cost-Effectiveness of Inpatient Continuous Glucose Monitoring.

作者信息

Veríssimo David, Pereira Beatriz R, Vinhais Joana, Ivo Catarina, Martins Ana C, Silva João N, Passos Dolores, Lopes Luís, Jácome de Castro João, Marcelino Mafalda

机构信息

Department of Endocrinology, Hospital das Forças Armadas, Lisbon, PRT.

出版信息

Cureus. 2024 Mar 12;16(3):e55999. doi: 10.7759/cureus.55999. eCollection 2024 Mar.


DOI:10.7759/cureus.55999
PMID:38476508
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10928466/
Abstract

Introduction Our department conducted a retrospective cohort study to compare the efficacy of continuous glucose monitoring devices versus capillary blood glucose in the glycemic control of inpatient type 2 diabetes on intensive insulin therapy in a Portuguese hospital. The use of continuous glucose monitoring devices was associated with improved glycemic control, including an increased number of glucose readings within target range and reduced hyperglycemic events, being safe concerning hypoglycemias. This is the cost-effectiveness analysis associated with these results. Aim The primary objective was to compare the cost-effectiveness of achieving glycemic control, defined as the number of patients within glycemic goals, between groups. Secondary endpoints included cost-effectiveness analyses of each time in range goal, and each percentual increment in time in range. Methods We defined each glycemic goal as: "readings within range (70-180 mg/dL) >70%", "readings below range (below 70 mg/dL) <4%", "severe hypoglycemia (below 54 mg/dL) <1%", "readings above range (above 180 mg/dL) <25%", "very high glycemic readings (above 250 mg/dL) <5%". Results Continuous glucose monitoring showed lower median cost per effect for the primary outcome (€11.1 vs. €34.9/patient), with lower cost for readings in range (€7.8 vs. €11.6/patient) and for both readings above range goals ("above 180mg/dL": €7.4 vs. €9.9/patient, and "above 250mg/dL": €6.9 vs. €17.4/patient). Conclusions There are no published data regarding the cost-effectiveness of continuous glucose monitoring devices in inpatient settings. Our results show that continuous glucose monitoring devices were associated with an improved glycemic control, at a lower cost, and endorse the feasibility of incorporating these devices into hospital settings, presenting a favorable cost-effective option compared to capillary blood glucose.

摘要

引言 我们科室进行了一项回顾性队列研究,以比较在葡萄牙一家医院中,持续葡萄糖监测设备与指尖血糖监测在接受强化胰岛素治疗的住院2型糖尿病患者血糖控制方面的疗效。使用持续葡萄糖监测设备与改善血糖控制相关,包括目标范围内血糖读数数量增加和高血糖事件减少,且在低血糖方面是安全的。这是与这些结果相关的成本效益分析。 目的 主要目标是比较两组之间实现血糖控制(定义为达到血糖目标的患者数量)的成本效益。次要终点包括每次处于目标范围内的成本效益分析,以及目标范围内时间的每个百分比增量的成本效益分析。 方法 我们将每个血糖目标定义为:“范围内读数(70 - 180mg/dL)>70%”、“范围以下读数(低于70mg/dL)<4%”、“严重低血糖(低于54mg/dL)<1%”、“范围以上读数(高于180mg/dL)<25%”、“非常高的血糖读数(高于250mg/dL)<5%”。 结果 对于主要结局,持续葡萄糖监测显示每效果的中位数成本较低(11.1欧元/患者 vs. 34.9欧元/患者),目标范围内读数的成本较低(7.8欧元/患者 vs. 11.6欧元/患者),以及高于范围目标的读数成本均较低(“高于180mg/dL”:7.4欧元/患者 vs. 9.9欧元/患者,“高于250mg/dL”:6.9欧元/患者 vs. 17.4欧元/患者)。 结论 关于住院环境中持续葡萄糖监测设备的成本效益,尚无已发表的数据。我们的结果表明,持续葡萄糖监测设备与改善血糖控制相关,成本更低,并支持将这些设备纳入医院环境的可行性,与指尖血糖监测相比,是一种具有良好成本效益的选择。

相似文献

[1]
Cost-Effectiveness of Inpatient Continuous Glucose Monitoring.

Cureus. 2024-3-12

[2]
Continuous Glucose Monitoring vs. Capillary Blood Glucose in Hospitalized Type 2 Diabetes Patients.

Cureus. 2023-8-21

[3]
Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis.

Front Public Health. 2022

[4]
Flash glucose monitoring reduces glycemic variability and hypoglycemia: real-world data from Spain.

BMJ Open Diabetes Res Care. 2020-3

[5]
Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial.

Diabetes Care. 2006-1

[6]
Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study.

Diabetes Technol Ther. 2015-6

[7]
Reliability of continuous glucose monitoring system in the inpatient setting.

J Clin Transl Endocrinol. 2021-7-7

[8]
The effectiveness of continuous subcutaneous insulin pumps with continuous glucose monitoring in outpatient adolescents with type 1 diabetes: A systematic review.

JBI Libr Syst Rev. 2012

[9]
The effects of aging and frailty on inpatient glycemic control by continuous glucose monitoring in patients with type 2 diabetes.

Diabetes Res Clin Pract. 2023-4

[10]
Near-Continuous Glucose Monitoring Makes Glycemic Control Safer in ICU Patients.

Crit Care Med. 2018-8

本文引用的文献

[1]
Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus.

Diabetol Metab Syndr. 2023-11-25

[2]
Continuous Glucose Monitoring vs. Capillary Blood Glucose in Hospitalized Type 2 Diabetes Patients.

Cureus. 2023-8-21

[3]
16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2023.

Diabetes Care. 2023-1-1

[4]
Cost-Effectiveness of a Real-Time Continuous Glucose Monitoring System Versus Self-Monitoring of Blood Glucose in People with Type 2 Diabetes on Insulin Therapy in the UK.

Diabetes Ther. 2022-12

[5]
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline.

J Clin Endocrinol Metab. 2022-7-14

[6]
Reliability of continuous glucose monitoring system in the inpatient setting.

J Clin Transl Endocrinol. 2021-7-7

[7]
Accuracy of Dexcom G6 Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients With Diabetes.

Diabetes Care. 2021-7

[8]
7. Diabetes Technology: .

Diabetes Care. 2021-1

[9]
Cost-effectiveness analysis of real-time continuous monitoring glucose compared to self-monitoring of blood glucose for diabetes mellitus in Spain.

J Eval Clin Pract. 2018-7-3

[10]
The Cost-Effectiveness of Real-Time Continuous Glucose Monitoring (RT-CGM) in Type 2 Diabetes.

J Diabetes Sci Technol. 2016-6-28

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