Reduction in Diabetes-Related Hospitalizations and Medical Costs After Dexcom G6 Continuous Glucose Monitor Initiation in People with Type 2 Diabetes Using Intensive Insulin Therapy

Katia L Hannah; Poorva M Nemlekar; Courtney R Green; Gregory J Norman

doi:10.1007/s12325-024-02851-8

Reduction in Diabetes-Related Hospitalizations and Medical Costs After Dexcom G6 Continuous Glucose Monitor Initiation in People with Type 2 Diabetes Using Intensive Insulin Therapy

Adv Ther. 2024 Apr 15. doi: 10.1007/s12325-024-02851-8. Online ahead of print.

Authors

Katia L Hannah¹, Poorva M Nemlekar¹, Courtney R Green¹, Gregory J Norman²

Affiliations

¹ Dexcom, Inc., 6340 Sequence Dr., San Diego, CA, 92121, USA.
² Dexcom, Inc., 6340 Sequence Dr., San Diego, CA, 92121, USA. greg.norman@dexcom.com.

PMID: 38619722
DOI: 10.1007/s12325-024-02851-8

Abstract

Introduction: Some people with type 2 diabetes (T2D) require intensive insulin therapy to manage their diabetes. This can increase the risk of diabetes-related hospitalizations. We hypothesize that initiation of real-time continuous glucose monitoring (RT-CGM), which continuously measures a user's glucose values and provides threshold- and trend-based alerts, will reduce diabetes-related emergency department (ED) and inpatient hospitalizations and concomitant costs.

Methods: A retrospective analysis of US healthcare claims data using Optum's de-identified Clinformatics^® Data Mart database was performed. The cohort consisted of commercially insured, CGM-naïve individuals with T2D who initiated Dexcom G6 RT-CGM system between August 1, 2018, and March 31, 2021. Twelve months of continuous health plan enrollment before and after RT-CGM initiation was required to capture baseline and follow-up rates of diabetes-related hospitalizations and associated healthcare resource utilization (HCRU) costs. Analyses were performed for claims with a diabetes-related diagnosis code in either (1) any position or (2) first or second position on the claim.

Results: A total of 790 individuals met the inclusion criteria. The average age was 52.8 (10.5) [mean (SD)], 53.3% were male, and 76.3% were white. For claims with a diabetes-related diagnosis code in any position, the number of individuals with ≥ 1 ED visit decreased by 30.0% (p = 0.01) and with ≥ 1 inpatient visit decreased by 41.5% (p < 0.0001). The number of diabetes-related visits and average number of visits per person similarly decreased by at least 31.4%. Larger relative decreases were observed for claims with a diabetes-related diagnosis code in the first or second position on the claim. Total diabetes-related costs expressed as per-person-per-month (PPPM) decreased by $341 PPPM for any position and $330 PPPM for first or second position.

Conclusion: Initiation of Dexcom G6 among people with T2D using intensive insulin therapy was associated with a significant reduction in diabetes-related ED and inpatient visits and related HCRU costs. Expanded use of RT-CGM could augment these benefits and result in further cost reductions.

Keywords: Intensive insulin therapy; Medical costs; Real-time continuous glucose monitoring; Retrospective analysis; Type 2 diabetes.