Continuous Glucose Monitoring (CGM) use in patients with diabetes mellitus type 1 is associated with higher healthcare costs, increased hospitalizations, and social disparities in a real-world setting: Analysis of adoption pattern, impact on health services utilization and cost of care in a large integrated health system
Background: With the rising prevalence of diabetes mellitus type 1 (DM type 1), continuous glucose monitoring (CGM) has emerged as a key management tool. While studies suggest CGM improves glycemic control, its broader impact on healthcare utilization and costs remains limited. This study evaluates...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
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| Series: | Diabetes Epidemiology and Management |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666970625000228 |
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| Summary: | Background: With the rising prevalence of diabetes mellitus type 1 (DM type 1), continuous glucose monitoring (CGM) has emerged as a key management tool. While studies suggest CGM improves glycemic control, its broader impact on healthcare utilization and costs remains limited. This study evaluates demographic and clinical variations between DM type 1 patients using CGM and non-CGM users; assessing healthcare utilization, glycemic outcomes, costs and impact on Durable Medical Equipment (DME). Methods: A retrospective cohort analysis was conducted using health insurance claims and electronic medical records from Allegheny Health Network (AHN) from 2019 to 2021. Patient eligibility required 36 months of continuous medical and drug coverage; insulin use and AHN affiliation. The cohort included 3007 patients, divided into CGM users and non-users. Additionally, patient data was stratified by demographics, social vulnerability index (SVI), healthcare use by per member per month (PMPM) and 1000 person-months. Results: CGM users had higher PMPM and utilization/1000 for all service types, except for DME, when compared to non-CGM users. There was a progressive increase in the cost of prescriptions among CGM users (prescription PMPM, 2019: $621.33, 2020: $723.97, 2021: $851.39). Non-CGM users had greater prescription-related expenses, comprising 43 % of total costs but a higher likelihood of achieving an HbA1c <9.0. Number of hospitalizations was significantly higher among CGM users compared to non-CGM users (18.4 % vs. 10.55 %, p < 0.001). CGM use was more common among non-Caucasian, non-English-speaking, and tobacco-using groups but declined with increasing SVI. CGM users had higher rates of frailty, depression, congestive heart failure and seizures. Conclusion: This study highlights the complexity of CGM uptake and its impact on healthcare costs in DM type 1 patients. Increased healthcare spending associated with CGM use raises concerns about cost-effectiveness and accessibility. Further studies are needed to assess disparities in CGM utilization and diabetes management including diabetes-related complications and associated costs across varying demographics and socioeconomic groups. |
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| ISSN: | 2666-9706 |