University of Colorado School of Medicine and Barbara Davis Center for Diabetes, Aurora, Colorado, USA.
University of Washington Medical School of Medicine, Seattle, Washington, USA.
Diabetes Obes Metab. 2024 Nov;26(11):5202-5210. doi: 10.1111/dom.15866. Epub 2024 Sep 12.
The real-world benefits of continuous glucose monitoring (CGM) in the broad type 2 diabetes (T2D) population are not well studied. Our study evaluated the impact of CGM use on health care resource utilization over 12 months in adults with T2D.
This retrospective cohort analysis used Optum's de-identified Market Clarity data of >79 million people to evaluate CGM use in people with T2D who were treated with non-insulin (NIT), basal insulin (BIT) and prandial insulin therapy (PIT). The primary outcomes were changes in all-cause hospitalizations, acute diabetes-related hospitalizations and acute diabetes-related emergency room visits during the 6- and 12-month post-index period following transition from blood glucose monitoring to CGM. A pre-specified subgroup analysis assessed glucose control and medication changes among people with T2D over 1 year.
The analysis included 74 679 adults with T2D (NIT; n = 25 269), (BIT; n = 16 264) and (PIT; n = 33 146). Significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations and acute diabetes-related emergency room visits were observed in the 6-month post-index period that were sustained during the 6-12 month post-index period (NIT, -10.1%, -31.0%, -30.7%; BIT, -13.9%, -47.6%, -28.2%; and PIT, -22.6%, -52.7%, -36.6%, respectively). A subgroup analysis of 6030 people showed mean glycated haemoglobin reductions at approximately 3 months, which were also sustained throughout the post-index period: NIT, -1.1 (0.05)%; BIT, -1.1 (0.06)%; and PIT, -0.9 (0.04)%, p < 0.0001.
CGM use in real-life across different therapeutic regimens in adults with T2D was associated with reductions in health care resource utilization with improved glucose control over 1 year.
在广泛的 2 型糖尿病（T2D）人群中，连续血糖监测（CGM）的实际获益尚未得到充分研究。本研究评估了在接受非胰岛素（NIT）、基础胰岛素（BIT）和餐时胰岛素治疗（PIT）的 T2D 成人中，CGM 使用对 12 个月内医疗资源利用的影响。
本回顾性队列分析使用 Optum 去识别的 Market Clarity 超过 7900 万人的数据，评估了从血糖监测转为 CGM 后 6 个月和 12 个月索引后期间，T2D 患者全因住院、急性糖尿病相关住院和急性糖尿病相关急诊就诊的变化。主要结局是评估 T2D 患者在 1 年内的血糖控制和药物变化的预先指定亚组分析。
分析包括 74679 名 T2D 成人（NIT；n=25269）、（BIT；n=16264）和（PIT；n=33146）。在索引后 6 个月观察到全因住院、急性糖尿病相关住院和急性糖尿病相关急诊就诊显著减少，并且在索引后 6-12 个月持续减少（NIT，-10.1%、-31.0%、-30.7%；BIT，-13.9%、-47.6%、-28.2%；PIT，-22.6%、-52.7%、-36.6%）。对 6030 人的亚组分析显示，约 3 个月时平均糖化血红蛋白降低，并且在整个索引后期间也保持不变：NIT，-1.1（0.05）%；BIT，-1.1（0.06）%；PIT，-0.9（0.04）%，p<0.0001。
在 T2D 成人中，不同治疗方案中使用 CGM 与医疗资源利用减少相关，并且在 1 年内改善了血糖控制。
