This clinical cost offset analysis compared rtCGM vs. SMBG in people with type 1 diabetes (T1D) applying results from a 3-year, nonrandomized, prospective, real-world clinical trial (COMISAIR). Clinical effects for HbA1c reduction using rtCGM vs. SMBG combined with MDI (-0.96%) or CSII (-0.71%) after 3 years were converted directly into an economic benefit and inflated ($U.S. 2020). The MDI group showed reduced 3-year event rates for severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) of 68% and 100%, respectively. The CSII group showed 50% and nearly 0% fewer SH and DKA events, respectively, using rtCGM vs. SMBG. Estimated costs for HbA1c reduction (low/high) along with SH and DKA events were taken from published literature and inflated ($U.S. 2020). Switching from SMBG to rtCGM would result in an estimated 487 and 238 fewer SH and DKA events, respectively, for the MDI group and 208 and 8 fewer SH and DKA events in the CSII group. Table 1 describes the potential economic benefit. Sustained reduction in HbA1c for rtCGM vs. SMBG represents over 95% of the potential economic value and per person savings range from $3,555-$6,747 after 3 years. Our modelling study demonstrates compelling clinical and economic benefits of sustained HbA1c control using rtCGM over SMBG in T1D.


J. Soupal: Advisory Panel; Self; Abbott. Consultant; Self; Medtronic, Roche Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc. J.J. Isitt: Employee; Self; Dexcom, Inc. G. Grunberger: Research Support; Self; Medtronic. M. Prazny: Speaker’s Bureau; Self; Novartis Pharmaceuticals Corporation, Roche Diabetes Care. Other Relationship; Self; Abbott, Boehringer Ingelheim International GmbH, Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi, Teva Pharmaceutical Industries Ltd. C. Parkin: Consultant; Self; Abbott, CeQur Corporation, Dexcom, Inc., DreaMed Diabetes, Novo Nordisk Inc., Onduo, Roche Diabetes Care, Valeritas, Inc. M.E. Minshall: Consultant; Self; Dexcom, Inc. P.M. Lynch: Employee; Self; Dexcom, Inc. Stock/Shareholder; Self; Dexcom, Inc.


Dexcom, Inc.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at