Continuous glucose monitors ‘cost-effective’ for diabetes

Continuous glucose monitors improve glucose control and add to quality of life for patients with type 1 diabetes, and are also cost-effective over manual testing with strips, according to US researchers.

They noted that while, such monitors offered significant, daily benefits to people with type 1 diabetes, providing near-real time measurements of blood glucose levels, they could be expensive.

Over the course of a six-month trial, the researchers found that use of a continuous glucose monitor (CGM) was cost-effective for adults with type 1 diabetes when compared to daily use of test strips.

During the trial, CGMs improved overall blood glucose control among the participants and reduced hypoglycemia, said the study authors from the University of Chicago Medicine.

Their study, published in the journal Diabetes Care, also simulated the costs and health effects of CGM use over the expected lifetime of patients.

It showed that CGMs increased quality of life by extending the amount of time patients enjoyed relatively good health that was free of complications, they said.

A CGM uses a tiny sensor inserted under the skin to test blood sugar levels 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, but newer models can work with apps on smartphones and smartwatches. This provides near-real time information and allows patients to quickly adjust their physical activity, food intake or insulin levels.

The new study involved 158 patients with type 1 diabetes who relied on multiple, daily injections of insulin, rather than an insulin pump.

Two-thirds of the patients were randomised to use CGMs, and the remaining third used the finger prick method with test strips and a meter to check their blood glucose.

At the end of the six-month trial, the total health care costs of using a CGM was £7,740, compared to £4,920 for manual testing. The cost differences were mostly due to the upfront cost of the CGM device, about £1,400.

But the CGM group saw reductions in their HbA1C levels and experienced fewer non-severe low blood glucose events, said the researchers.

The CGM was also projected to reduce the risk of complications from type 1 diabetes and increase quality-adjusted life years by .54, basically adding six months of good health.

Senior study author Dr Elbert Huang, associate director of the Chicago Center for Diabetes Translation Research, said: “If you map out the lifetime of a patient, it’s impressive.

“The CGM adds years of life and years of quality life,” he said. “While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs.

“The CGM looks like a very valuable technology, one that doesn’t cause harm and makes people’s lives better,” he said. “Hopefully, this will become an important part of the decision-making process to make the CGM available to more people.”

He noted that advances in CGM technology would also continue to lower costs, as it was further integrated 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,” Dr Huang said.

“Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications,” he said. “It empowers patients to manage their own health.”