Real-time continuous glucose monitoring related to reductions in inpatient and emergency department encounters and their associated costs among non-insulin-treated people with type 2 diabetes.

Abstract

The use of real-time continuous glucose monitoring (RT-CGM) is well established to support people with type 2 diabetes (T2D) in achieving adequate glycemic control. However, health care resource utilization (HCRU) studies have previously tended to focus on individuals with T2D who are receiving treatment with insulin. To examine the impacts of RT-CGM on inpatient and emergency department (ED) HCRU in non-insulin-treated people. This retrospective study analyzed US administrative claims data from Optum's Clinformatics Data Mart database between September 1, 2016, and December 31, 2024. Continuous glucose monitoring (CGM)-naive individuals with T2D who initiated a Dexcom G-series RT-CGM between September 1, 2017, and December 31, 2023, were included (index date: first RT-CGM claim). Change in the number of all-cause and diabetes-related encounters by service location (inpatient and ED) and the mean change in associated medical costs were assessed over a 6-month pre-index period (baseline) and in 2 consecutive 6-month segments post-index (0-6 months and 7-12 months). Stratification by baseline HCRU encounter frequency unique to service location included the following: nonutilizers, zero baseline encounters; low utilization, 1 to 2 baseline encounters; high utilization, 3 or more baseline encounters. The analysis included 4,463 people with T2D. Decreases were observed in the numbers of inpatient and ED encounters among those using such encounters in the baseline period. Those considered that low utilizers (1-2 baseline encounters) experienced a 66% decrease in inpatient encounters and 63% decrease in ED encounters, whereas high utilizers (≥3 encounters) experienced a 67% decrease in inpatient encounters and 68% decrease in ED encounters. These decreases coincided with significant reductions in associated costs. People with T2D who were not receiving insulin treatment and have had recent inpatient or ED encounters had lower observed HCRU after the initiation of RT-CGM with Dexcom G-series systems.