991-P: Reduction in Diabetes-Related Hospitalizations and Medical Costs after Real-Time Continuous Glucose Monitor (rtCGM) Initiation in Patients with Type 2 Diabetes (PWT2D) on Intensive Insulin Therapy (IIT)

This study evaluated changes in diabetes-related hospitalizations and healthcare resource utilization (HCRU) costs after rtCGM initiation in PWT2D on IIT. Retrospective analysis of US healthcare claims data using Optum’s Clinformatics® database was conducted. The cohort included CGM naïve PWT2D on IIT who initiated rtCGM (Dexcom G6) between 8/1/2018 through 3/31/2021 (index date=earliest observed pharmacy claim). Diabetes-related (e.g., diabetic ketoacidosis, hyperglycemia and hypoglycemia) hospitalizations (ER and inpatient visits) and associated HCRU costs were assessed 12-months pre- and post-index. Hospitalizations were expressed as changes in the number of visits. Changes in diabetes-related HCRU costs were reported as per-person-per-month (PPPM) costs. Hospitalizations and HCRU costs were defined as claims with a diabetes-related diagnosis code in the 1st or 2nd position on the claim. A total of 790 PWT2D (average age=52.8 (sd=10.5) years, 46.7% female) rtCGM users on IIT with commercial health insurance met inclusion criteria. A 50% reduction (p<0.0001) in the number of diabetes-related inpatient visits after rtCGM initiation was observed (baseline n=132, follow-up n=66). Similarly, after rtCGM initiation, a 47% reduction (p<0.05) in the number of diabetes-related ER visits occurred (baseline n=85, follow up n=45). Average PPPM diabetes-related hospitalization medical costs decreased by $329.53 (p<0.05). HCRU cost reductions were driven by reduced diabetes-related inpatient medical costs (-$308.46 PPPM). Payer claims showed that hyperglycemia and ketoacidosis were the most common reasons for hospitalizations 12-months pre- and post-device initiation. Findings suggest that rtCGM initiation may contribute to reduced HCRU for PWT2D on IIT by way of improving glycemic control.