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Impact of continuous glucose monitoring on emergency department visits and all-cause hospitalization rates among Medicaid beneficiaries with type 2 diabetes treated with multiple daily insulin or basal insulin therapy.
- Source :
-
Journal of managed care & specialty pharmacy [J Manag Care Spec Pharm] 2024 Oct; Vol. 30 (10-b Suppl), pp. S21-S29. - Publication Year :
- 2024
-
Abstract
- Background: The increasing prevalence of diabetes in the United States continues to drive a steady rise in health care resource utilization, especially emergency department visits and all-cause hospitalizations, and the associated costs.<br />Objective: To investigate the impact of continuous glucose monitoring (CGM) on emergency department visits and all-cause hospitalizations among Medicaid beneficiaries with type 2 diabetes (T2D) treated with multiple daily insulin injections (MDIs) or basal insulin therapy (BIT) in a real-world setting.<br />Methods: In this retrospective, 12-month analysis, we used the Inovalon Insights claims dataset to evaluate the effects of CGM acquisition on emergency department visits and all-cause hospitalizations in the Managed Medicaid population. The analysis included 44,941 beneficiaries with T2D who were treated with MDIs (n = 35,367) or BIT (n = 9,574). Primary outcomes were changes in the number of emergency department visits and all-cause hospitalizations following 6 months after acquisition of CGM (post-index period) compared with 6 month prior to CGM acquisition (pre-index period). The first claim for CGM was the index date. Inclusion criteria were as follows: aged younger than 65 years, diagnosis of T2D, claims for short- or rapid-acting insulin (MDI group) or basal insulin (not rapid-acting) (BIT group), acquisition of a CGM device between January 1, 2017, and September 30, 2022, and continuous enrollment in their health plan throughout the pre-index and post-index periods.<br />Results: In the MDI group, all-cause inpatient hospitalization rates decreased from 3.25 to 2.29 events/patient-year (hazard ratio = 0.12; 95% CI = 0.11-0.13; P < 0.001) and emergency department visit rates decreased from 2.15 to 1.86 events/patient-year (hazard ratio = 0.52; 95% CI = 0.50-0.53; P < 0.001). In the BIT group, all-cause inpatient hospitalization rates decreased from 1.63 to 1.39 events/patient-year (hazard ratio = 0.11; 95% CI = 0.09-0.12; P < 0.001) and emergency department visit rates decreased from 1.60 to 1.43 events/patient-year (hazard ratio = 0.47; 95% CI = 0.44-0.50; P < 0.001).<br />Conclusions: Acquisition of CGM is associated with significant reductions in emergency department visits and all-cause hospitalizations among people with T2D treated with MDIs or BIT.
- Subjects :
- Humans
Female
Male
Middle Aged
Retrospective Studies
United States
Adult
Blood Glucose drug effects
Blood Glucose metabolism
Aged
Continuous Glucose Monitoring
Emergency Room Visits
Diabetes Mellitus, Type 2 drug therapy
Diabetes Mellitus, Type 2 blood
Emergency Service, Hospital statistics & numerical data
Hospitalization statistics & numerical data
Medicaid statistics & numerical data
Insulin administration & dosage
Insulin therapeutic use
Hypoglycemic Agents administration & dosage
Hypoglycemic Agents therapeutic use
Blood Glucose Self-Monitoring
Subjects
Details
- Language :
- English
- ISSN :
- 2376-1032
- Volume :
- 30
- Issue :
- 10-b Suppl
- Database :
- MEDLINE
- Journal :
- Journal of managed care & specialty pharmacy
- Publication Type :
- Academic Journal
- Accession number :
- 39347973
- Full Text :
- https://doi.org/10.18553/jmcp.2024.30.10-b.s21