(143) Clinical, Economic, and Patient-Reported Outcomes from Continuous Glucose Monitoring in Patients with Type 2 Diabetes

Background: : While continuous glucose monitoring (CGM) is well-established in the management of insulin-treated diabetes, the utility in individuals with non-insulin-treated type 2 diabetes (T2D) has been less studied.

Objective: : Evaluate the impact of CGM use in patients with T2D.

Methods: : This prospective study enrolled adult patients with poorly controlled T2D (HbA1c ≥8%) and no current insulin use, with a target enrollment of 200 patients. Patients initiated Dexcom G7® CGM and were followed for six months. Changes in HbA1c and ADDQoL were assessed in all patients. Glycemic events, healthcare resource utilization, and medication utilization were assessed in a subgroup with supplemental claims data. Paired statistical tests compared outcomes pre- and post-CGM initiation. The pre-CGM baseline was defined as 3 months before CGM initiation.

Results: : A total of 217 patients were enrolled, and a subgroup of 76 patients had available claims data. Patients were predominantly White (75%) and male (58%) and had an average age of 58 years. The most prevalent comorbidities included hyperlipidemia (73%) and hypertension (70%); additionally, 44% of patients were obese. Standard classes of medications at baseline included metformin (83%), SGLT2 inhibitors (49%), and GLP1 receptor agonists (42%). HbA1c significantly declined at 3 and 6 months post-CGM (–1.28% and –1.42%; p< 0.001). ADA (HbA1c < 7%) and HEDIS (HbA1c < 8%) target attainment rose from 0% at baseline to 26% and 51%, respectively, at 6 months. Hyperglycemic events declined (–30.1% from 0-3 months; –16.3% from 3-6 months) compared to the baseline period (-3 to 0 months) but was not statistically significant. Significant changes in the rate of ED, inpatient, and outpatient encounters pre- and post-CGM were not observed. Adherence for antidiabetic medications (PDC ≥80%) showed a non-significant decline over the study period. The number of medications per patient stayed consistent during the study period (–0.05 at 0–3 months; 0.00 at 3–6 months). The proportion of patients responding that their present diabetes-related quality of life was good, very good, or excellent increased from 64% at baseline to 89% and 87% at 3 and 6 months, respectively.

Conclusions: : CGM use in non-insulin-treated T2D patients was associated with significant improvements in glycemic control and perceived quality of life, with stable healthcare utilization and medication therapy. These findings support expanded implementation and reimbursement of CGM in this population.

Sponsorship:: Dexcom, Inc.