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
Department of Endocrinology, Hospital das Forças Armadas, Lisbon, PRT.
Cureus. 2024 Mar 12;16(3):e55999. doi: 10.7759/cureus.55999. eCollection 2024 Mar.
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.
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。
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