May 17, 2024
CGM Technology and Digital Health
Article / Publication

This article provides a comprehensive summary of the latest discoveries in the category of continuous glucose monitoring (CGM). It compiles the most recent scientific findings in an easy-to-read format, complete with hyperlinks and QR codes to full-text articles and abstracts. Read here to learn how increased implementation and expanded access to CGM may improve clinical and economic outcomes and reduce diabetes-related healthcare utilization and costs.

Key Topics:

  • 2024 Clinical Practice Updates and Quality Measure Changes
  • Emerging Evidence for CGM Use in Non-Intensively Treated Type 2 Diabetes
  • Reduction in Healthcare Resource Utilization and Mortality
  • Real-World Data Showing CGM Reduces Costs
  • Utilization of GLP-1 Agonists in Conjunction with CGM
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May 15, 2024
Coverage and Benefit Design
Article / Publication

A poster presented at the Academy of Managed Care Pharmacy’s (AMCP) annual meeting in New Orleans, LA, shared data from a health initiative by Metro Nashville Public Schools. The employer provided CGM devices as a pharmacy benefit without prior authorization. This policy change led to a two-fold increase in CGM utilization among employees aged 18 to 64 years with T1D and T2D regardless of treatment regimen. The retrospective analysis, covering 184 participants, showed significant improvements in glycemic control associated with CGM use. Specifically, average A1c decreased from 8.7% to 7.9% and from 7.6% to 6.8% among those with T2D treated with insulin and not-treated with insulin, respectively. Additionally, CGM use resulted in a significant improvement in the proportion of individuals meeting the HEDIS and ADA HbA1c targets of <8.0% and <7.0%, respectively. These results underscore the potential benefits of CGM for improving diabetes management through streamlined health care payer and purchaser coverage.

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May 15, 2024
CGM Technology and Digital Health
Article / Publication / CGM Best Practices

The poster outlines best practices for health plan coverage and access to Continuous Glucose Monitoring (CGM) for diabetes management, emphasizing the technology’s transformative impact on care. It recommends aligning coverage criteria with current medical evidence, enhancing utilization oversight, and improving access for underserved populations. Strategies include offering CGM under pharmacy benefits, educating healthcare providers and patients, and developing support systems for at-risk groups. The best practices, derived from expert interviews, a national survey, and a workshop, aim to assist health plan decision makers in optimizing diabetes outcomes and managing healthcare costs efficiently.

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April 28, 2024
Clinical Outcomes
Article / Publication

Among 47 patients enrolled in a cardiovascular disease (CVD) outpatient program, CGM use was associated with improved glycemic and cardiometabolic outcomes. In the two-phase crossover study, participants were required to have T2D not treated with insulin therapy, an HbA1c >7%, and an obesity classification (BMI ≥30 kg/m2). Through 90 days of follow-up, CGM use was associated with a reduction in average glucose (184.0 to 147.2 mg/dL, P<0.001), an increase in time in range (57.8 to 82.8%, P<0.001), and a trend towards lower glycemic variability (26.2% to 23.8%). CGM users also experienced significant reductions in HbA1c, body mass index (BMI), triglycerides, blood pressure, total cholesterol, diabetes distress, and 10-year predicted risk for atherosclerotic cardiovascular disease (P<0.05 for all). These findings are pertinent to managed care and payer professionals seeking to better manage outcomes in T2D with comorbid CVD in health plan populations.

Reed J, Dong T, Eaton E, Friswold J, Porges J, Al-Kindi SG, Rajagopalan S, Neeland IJ. Continuous glucose monitoring for glycaemic control and cardiovascular risk reduction in patients with type 2 diabetes not on insulin therapy: A clinical trial. Diabetes Obes Metab. 2024 Apr 28. doi: 10.1111/dom.15608. Epub ahead of print.

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April 15, 2024
Clinical Outcomes
Article / Publication

In a real-word study analyzing 12 months of pre- and post-CGM-initiation US claims data, researchers found that CGM utilization was associated with lower hospital use and diabetes-related costs in intensive insulin-treated T2D. Among the 790 individuals who met the inclusion criteria, the number with ≥1 ED visit decreased by 30.0% (P=0.01) and with ≥1 inpatient visit decreased by 41.5% (P<0.0001). The number of diabetes-related visits and average number of visits per person likewise decreased by at least 31.4%. Total diabetes-related costs expressed as per-person-per-month (PPPM) also decreased by $341 PPPM. Managed care and payer professionals will find this analysis of interest in assessing the value of CGM as a cost-reduction intervention in the management of T2D among plan members.

Hannah KL, Nemlekar PM, Green CR, Norman GJ. Reduction in Diabetes-Related Hospitalizations and Medical Costs After Dexcom G6 Continuous Glucose Monitor Initiation in People with Type 2 Diabetes Using Intensive Insulin Therapy. Adv Ther. 2024 Apr 15. doi: 10.1007/s12325-024-02851-8. Epub ahead of print. PMID: 38619722.

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April 11, 2024
Clinical Outcomes
Article / Publication

A retrospective cohort study published in JAMA Network Open showed that CGM use was associated with lower odds of developing diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR). Among 550 adults with type 1 diabetes (T1D) included in the analysis, 62.7% patients used CGM, 58.2% used an insulin pump, and 47.5% used both. After adjusting for age, sex, race and ethnicity, diabetes duration, microvascular and macrovascular complications, insurance type, and mean HbA1c, CGM was associated with lower odds of DR (odds ratio [OR], 0.52; 95% CI, 0.32-0.84; P=0.008) and PDR (OR, 0.42; 95% CI, 0.23-0.75; P =0.004), compared with no CGM use. These findings show that CGM can be beneficial preventing DR—the leading cause of blindness among adults in the United States—even in individuals with well managed T1D.

Liu TYA, Shpigel J, Khan F, Smith K, Prichett L, Channa R, Kanbour S, Jones M, Abusamaan MS, Sidhaye A, Mathioudakis N, Wolf RM. Use of Diabetes Technologies and Retinopathy in Adults With Type 1 Diabetes. JAMA Netw Open. 2024 Mar 4;7(3):e240728.

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March 4, 2024
CGM Technology and Digital Health
CE Activities

Download a comprehensive listing of continuing education programs for pharmacists, physicians and nurses on the topic of CGM.

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January 10, 2024
CGM Technology and Digital Health
Clinical Outcomes
Guidelines / Policy

The ADA Standards of Care include all of of the organization’s current clinical practice recommendations and are intended to provide clinicians, patients, researchers, payers, and others stakeholders with best practices in diabetes management, general treatment goals, and tools to evaluate the quality of care. The recommendations are based on an extensive review of the clinical diabetes literature, supplemented with input from ADA staff and the medical community at large. These comprehensive guidelines are updated annually, or more frequently online if new evidence or regulatory changes merit immediate incorporation In alignment with previous versions of the ADA Standards of Care, the 2024 update highlights the clinical benefit of CGM across a wide range of patient types based on a growing body of evidence.

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January 10, 2024
Coverage and Benefit Design
Article / Publication / CGM Best Practices

Leveraging an opportunity for health plans to support improved patient outcomes in diabetes management with CGM, AMCP sponsored a multifaceted initiative to identify best practices. The program approach consisted of expert interviews, a national payer survey, and an expert panel workshop with clinical experts and managed care stakeholders. In addition to a national webcast to communicate the program findings, this supplement published in the Journal of Managed Care and Specialty Pharmacy summarizes current evidence and consensus recommendations for CGM to support the effective management of diabetes in health plan populations. The supplement also presents the findings from the national payer survey and describes expert-supported health plan best practices around streamlined but evidence-based coverage and access to CGM. Managed care and payer professionals will find this information useful in making collaborative, evidence-based decisions to optimize outcomes among members with diabetes.

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January 10, 2024
Coverage and Benefit Design
Infographic

Updated January 2024

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