Improved Glycemic Control and Continuous Glucose Monitoring (CGM) Utilization: A Comparison of Real-Time CGM and Intermittent Scanning CGM

Evolution of CGM technology has equipped the market with different systems. This study compared two types of CGM devices, real-time (rt) CGM and intermittently scanned (is) CGM on clinical outcomes among persons with diabetes using intensive insulin therapy. A retrospective analysis was performed using Optum Clinformatics® Database comprised of administrative claims data. CGM naïve patients with type 1 or type 2 diabetes initiated rtCGM (Dexcom G6®) or isCGM (FreeStyle Libre®) between 8/1/2018 through 3/31/2020 (index date = earliest observed pharmacy claim) . Patients with continuous health plan enrollment 12-months pre and post index date, age ≥18 years, with ≥1 sensor pharmacy claim, with A1C lab values during baseline and follow up were included in the study. Outcomes were the proportion reaching a target A1C of < 7% and the change in number of severe hypoglycemia (SH) inpatient/ER visits. A total of 272 rtCGM (average age = 47.3 (sd = 13.1) years, 46.7% female) and 467 isCGM (average age = 50.9 (sd = 12.7) years, 37.5% female) patients on intensive insulin therapy met inclusion criteria. After adjusting for baseline, rtCGM users were nearly twice as likely, compared to isCGM users, to reach an A1C of < 7% (OR = 1.97, 95% CI, 1.32 to 2.95, p<0.01) . A significant reduction was found in SH events from 40 to 13 after rtCGM initiation (baseline mean = 0.15, sd=0.49; and follow up mean = 0.05, sd=0.23, p<0.01) . For isCGM users SH events reduced from 42 to 32 (mean = 0.09, sd=0.44; and follow up mean 0.07, sd=0.35, p=0.239) . Findings suggest CGM naïve patients benefit from rtCGM compared to isCGM through significantly greater numbers achieving A1C < 7%. Improved access to rtCGM should help more patients achieve optimal glycemic control and reduce health care encounters due to SH. Disclosure K.Hannah: Employee; Dexcom, Inc. P.Nemlekar: None. D.A.Price: Employee; Dexcom, Inc. G.J.Norman: Employee; Dexcom, Inc.