1927-LB: Impact of Continuous Glucose Monitoring Use on Hospitalizations in People with Type 2 Diabetes—Real-World Analysis

IF 6.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Pub Date : 2024-07-19 DOI:10.2337/db24-1927-lb

SATISH K. GARG, IRL B. HIRSCH, ENRICO REPETTO, JANET K. SNELL-BERGEON, BRIAN ULMER, CHRISTOPHER PERKINS, RICHARD M. BERGENSTAL

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Abstract

Introduction & Objective: The increasing prevalence of diabetes in the US continues to drive a steady rise in healthcare resource utilization. The real-world impact of continuous glucose monitoring (CGM) on hospitalizations in a broad type 2 diabetes population is not completely understood. Methods: In this retrospective analysis, we used Optum's de-identified Market Clarity data of >79 million people to evaluate CGM use in 74,264 people with type 2 diabetes who were treated with non-insulin (NIT; n=25,788), basal insulin (BIT; n=25,292), and prandial insulin therapy (PIT; n=23,184). The primary outcomes were changes in all-cause hospitalizations (ACH), acute diabetes-related hospitalizations (ADH), and acute diabetes-related emergency room visits (ADER) during the 6- and 12-months post-index period. Results: ACH, ADH, and ADER were significantly reduced in the first 6 months (post-index) in all three groups: NIT (14%, 32%, 30%), BIT (25%, 57%, 37%), PIT (25%, 54%, 36%) respectively. (Figure 1) The reductions were sustained during 6-12 months in NIT (10%, 31%, 30%), BIT (23%, 56%, 34%), and PIT (19%, 49%, 36%) respectively (all p<0.0001). Conclusion: The use of CGM in real-world across different therapeutic regimes in people with type 2 diabetes was associated with significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations and ER visits. Disclosure S.K. Garg: Research Support; Eli Lilly and Company. Advisory Panel; Medtronic. Research Support; Medtronic. Advisory Panel; Novo Nordisk. Research Support; DarioHealth Corp., Dexcom, Inc., Diasome. Advisory Panel; Roche Diabetes Care. I.B. Hirsch: Advisory Panel; Abbott. Research Support; Dexcom, Inc. Advisory Panel; Roche Diabetes Care. Research Support; MannKind Corporation, Tandem Diabetes Care, Inc. Advisory Panel; embecta. Research Support; Tandem Diabetes Care, Inc. Advisory Panel; Vertex Pharmaceuticals Incorporated. E. Repetto: Employee; Roche Diabetes Care. J.K. Snell-Bergeon: None. B. Ulmer: Employee; Roche Diabetes Care. C. Perkins: Employee; Roche Diabetes Care. R.M. Bergenstal: Other Relationship; Abbott. Research Support; Arkray Marketing. Consultant; Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur. Other Relationship; Dexcom, Inc., Eli Lilly and Company. Consultant; embecta, Hygieia. Research Support; Insulet Corporation. Consultant; MannKind Corporation. Other Relationship; Medtronic, Novo Nordisk. Consultant; Onduo LLC, Roche Diabetes Care. Other Relationship; Sanofi. Research Support; Tandem Diabetes Care, Inc. Other Relationship; UnitedHealth Group. Consultant; Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S. Funding Roche Diagnostics, Diabetes Care

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1927-LB：连续血糖监测的使用对 2 型糖尿病患者住院治疗的影响--真实世界分析

导言与目标：美国糖尿病患病率不断上升，导致医疗资源利用率持续上升。连续血糖监测（CGM）对广大 2 型糖尿病患者住院治疗的实际影响尚不完全清楚。方法：在这项回顾性分析中，我们使用 Optum 的去标识化 Market Clarity 数据，对 74,264 名接受非胰岛素 (NIT；人数=25,788)、基础胰岛素 (BIT；人数=25,292) 和餐前胰岛素治疗 (PIT；人数=23,184) 的 2 型糖尿病患者使用 CGM 的情况进行了评估。主要结果是在指数期后的 6 个月和 12 个月期间，全因住院率 (ACH)、急性糖尿病相关住院率 (ADH) 和急性糖尿病相关急诊就诊率 (ADER) 的变化。结果：在指数发布后的前 6 个月中（指数发布后），所有三组的 ACH、ADH 和 ADER 均明显减少：NIT（分别为 14%、32%、30%）、BIT（分别为 25%、57%、37%）、PIT（分别为 25%、54%、36%）。(图 1）NIT 组（10%、31%、30%）、BIT 组（23%、56%、34%）和 PIT 组（19%、49%、36%）的降幅在 6-12 个月内保持不变（所有 p<0.0001）。结论在不同治疗方案的真实世界中，2 型糖尿病患者使用 CGM 可显著降低全因住院率、糖尿病相关急性住院率和急诊就诊率。披露 S.K. Garg：研究支持；礼来公司。顾问团；美敦力。研究支持；美敦力。顾问团；诺和诺德公司。研究支持；DarioHealth Corp.顾问小组；罗氏糖尿病护理公司。I.B. Hirsch：顾问团；雅培。研究支持；Dexcom, Inc.顾问小组；罗氏糖尿病护理公司。研究支持；MannKind Corporation、Tandem Diabetes Care, Inc.顾问团；embecta.研究支持；Tandem Diabetes Care, Inc.顾问团；Vertex Pharmaceuticals Incorporated。E. Repetto：罗氏糖尿病护理公司雇员。J.K. Snell-Bergeon：无。B. Ulmer：罗氏糖尿病护理公司员工。C. Perkins：罗氏糖尿病护理公司员工。R.M. Bergenstal：其他关系；雅培。研究支持；Arkray Marketing。顾问；Ascensia Diabetes Care、Bigfoot Biomedical, Inc.、CeQur。其他关系；Dexcom 公司、礼来公司。顾问；embecta、Hygieia。研究支持；Insulet 公司。顾问；MannKind 公司。其他关系；美敦力、诺和诺德。顾问；Onduo LLC、罗氏糖尿病护理公司。其他关系；赛诺菲。研究支持；Tandem Diabetes Care, Inc.其他关系；联合健康集团。顾问；Vertex Pharmaceuticals Incorporated、Zealand Pharma A/S。资助罗氏诊断公司、糖尿病护理公司。

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.