Background: National guidelines stipulate lifestyle and glycemic management for diabetes care. However, diabetes control remains inadequate for many people. CGM devices can improve detection and awareness of dysglycemia. Examining glycemic changes related to real-world CGM use can inform clinical and policy decisions about implementing this technology.
Methods: This was a retrospective observational study of medical claims data from Aetna’s fully insured member population. The index date was the first claim for CGM from 1/1/2019 through 12/31/2021. A1c was measured in the 3m prior to the index date and during the follow-up period. Patients were classified as having T1D or T2D based on ICD10 codes.
Results: A cohort of 7,814 patients (25% T1D, mean age = 58, 43% Medicare insured, 46% female, 56% white) met the inclusion criteria. A subset (n = 1,127) had A1c measures at baseline and in the last 3m of follow-up. Across all patient groups, A1c at baseline was > 8.0 with statistically significant reductions at end of follow-up (Table). Analysis of all available A1c measures indicated reductions occurred primarily in the first 3m of CGM initiation and were sustained over the 12m.
Conclusion: CGM was associated with clinically meaningful and sustained reductions in A1c for patients with T1D and T2D, suggesting a population approach to CGM use for all patients with diabetes may be warranted.
G.J. Norman: Employee; Dexcom, Inc. J. Fernandes: Employee; CVS Caremark. Research Support; Dexcom, Inc., Pfizer Inc., Novo Nordisk, Sage Pharmaceuticals, Becton, Dickinson and Company, Aetion, Inc., Boehringer-Ingelheim. P. Nemlekar: Employee; Dexcom, Inc. L. Lupton: Employee; CVS Health. A. Berk: Employee; CVS Caremark.
