Continuous glucose monitors proven cost-effective, add to quality of life for diabetics

April 12, 2018, University of Chicago Medical Center
Newer models of continuous glucose monitors can transmit data to smartphones and smartwatches. Credit: Matt Wood, UChicago Medicine

Continuous glucose monitors (CGM) offer significant, daily benefits to people with type 1 diabetes, providing near-real time measurements of blood sugar levels, but they can be expensive. A new study by researchers from the University of Chicago Medicine, based on a 6-month clinical trial, finds that use of a CGM is cost-effective for adult patients with type 1 diabetes when compared to daily use of test strips. The results are well within the thresholds normally used by insurance plans to cover medical devices. During the trial, CGMs improved overall blood glucose control for the study group and reduced hypoglycemia, or low blood sugar episodes.

The study, published April 12, 2018 in Diabetes Care, a journal from the American Diabetes Association, also simulated the costs and health effects of CGM use over the expected lifetime of . It showed that CGMs also increased quality of life by extending the amount of time patients enjoy relatively good health, free of complications.

"If you map out the lifetime of a patient, it's impressive. The CGM adds years of life and years of quality life," said Elbert Huang, MD, Associate Director of the Chicago Center for Diabetes Translation Research at the University of Chicago and senior author of the study. "While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs."

A continuous glucose monitor uses a tiny sensor inserted under the skin to test every few minutes throughout the day and wirelessly sends those data to a monitor. The first generation of CGMs transmitted data to a stand-alone electronic device that looks like a pager, but newer models can work with apps on smartphones and smartwatches. This provides near-real time information and allows diabetics to adjust their physical activity, food intake or insulin levels quickly, preventing severe high or episodes.

The study was a randomized trial of 158 patients with type 1 diabetes who relied on multiple, daily injections of insulin (not an insulin pump). Two-thirds of the group used CGMs, and the remaining third used the finger prick method with and a meter to check their blood sugars.

At the end of the six-month trial, the total health care costs of using a CGM was $11,032, compared to $7,236 for manual testing. The cost differences were mostly due to the upfront cost of the CGM device, about $2,500. But the CGM group saw reductions in their hemoglobin A1C levels, a common measure of blood sugar control, and experienced fewer non-severe low events.

The researchers also used a statistical model to simulate costs and health effects of CGM use over the average expected lifetime of patients. The model calculated a value called quality-adjusted life years (QALYs) for each patient, which represents the amount of time they live free of any complications or serious medical incidents. In the lifetime analysis, the CGM was projected to reduce the risk of complications from type 1 diabetes and increase QALYs by .54, basically adding six months of good health.

The analysis calculated an incremental cost-effectiveness ratio, which shows the difference in costs for a treatment, in this case the CGM vs daily test strips, over the health benefit it adds, or the quality of life years. The cost-effectiveness ratio for the CGM was about $100,000 per QALY for the overall population. This is well below the threshold insurance plans and government agencies such as Medicare normally use to decide whether or not to cover a new treatment or medical device. The ratio was calculated based on the recommendation to use a CGM sensor for seven days, but if that use was extended to 10 days, as many people do, that ratio was reduced to about $33,000 per QALY.

"Based on this analysis, the CGM looks like a very valuable technology, one that doesn't cause harm and makes people's lives better," Huang said. "Hopefully, this will become an important part of the decision-making process to make the CGM available to more people."

Advances in CGM technology will also continue to lower , as it further integrates with software and everyday digital devices such as smartphones.

"It hints at a future of chronic disease management that's more cost effective and gives patients more control," Huang said. "Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications. It empowers patients to manage their own health."

Explore further: Personalized blood sugar goals can save diabetes patients thousands

More information: "Cost-effectiveness of Continuous Glucose Monitoring for Adults with Type 1 Diabetes Compared with Self-Monitoring of Blood Glucose: the DIAMOND Randomized Trial," Diabetes Care (2018).

Related Stories

Personalized blood sugar goals can save diabetes patients thousands

December 11, 2017
A cost analysis by researchers at the University of Chicago Medicine shows treatment plans that set individualized blood sugar goals for diabetes patients, tailored to their age and health history, can save $13,546 in health ...

Providing free supplies to low-income families improves type 1 diabetes

March 20, 2018
Providing free supplies of insulin and blood glucose test trips to families with type 1 diabetes in low- and lower-middle income families can result in improved blood-sugar control and diabetes-related knowledge, a new study ...

Experts recommend continuous glucose monitors for adults with type 1 diabetes

September 26, 2016
The Endocrine Society today issued a Clinical Practice Guideline recommending continuous glucose monitors (CGMs) as the gold standard of care for adults with Type 1 diabetes.

Diabetics may often fare poorly in hospice care

January 4, 2018
(HealthDay)—Decisions about diabetes care can become harder as people age, and that may be especially true for those needing hospice care.

FDA OKs continuous blood sugar monitor without finger pricks (Update)

September 28, 2017
U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.

Continuous glucose monitors warn of low blood sugar threat

November 28, 2017
Continuous glucose monitors (CGM) can protect individuals who have had type 1 diabetes for years and are at risk of experiencing dangerously low blood sugar by increasing their awareness of the symptoms, according to a study ...

Recommended for you

Does diabetes damage brain health?

December 14, 2018
(HealthDay)—Diabetes has been tied to a number of complications such as kidney disease, but new research has found that older people with type 2 diabetes can also have more difficulties with thinking and memory.

Researchers study abnormal blood glucose levels of discharged patients

December 14, 2018
University of Minnesota Medical School researchers decided to delve into an area where little data currently exists. They wanted to know what happens after these patients with abnormal blood glucose measurements are discharged? ...

Researchers zero in on potential therapeutic target for diabetes, associated diseases

December 14, 2018
A recent study led by researchers in Texas A&M University's department of nutrition and food science shows how a novel regulatory mechanism serves as an important biomarker for the development of diabetes, as well as a potential ...

Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes

December 11, 2018
Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes.

Millions of low-risk people with diabetes may be testing their blood sugar too often

December 10, 2018
For people with Type 2 diabetes, the task of testing their blood sugar with a fingertip prick and a drop of blood on a special strip of paper becomes part of everyday life.

Very low calorie diets trialled by NHS to tackle diabetes

December 7, 2018
Hundreds of thousands of people will receive NHS help to battle obesity and type 2 diabetes under radical action set out by Simon Stevens, Chief Executive of NHS England.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.