789-P: Self-Care for Blood Glucose Monitoring (BGM) in Teens with Type 1 Diabetes (T1D): Impact of Real-Time Positive and Negative Affect

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 789-P
Author(s):  
AMIT SHAPIRA ◽  
LISA K. VOLKENING ◽  
JOSHUA BORUS ◽  
LORI M. LAFFEL
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Negative Affect ◽  
Real Time ◽  
Glucose Monitoring ◽  
Self Care ◽  
Blood Glucose Monitoring ◽  
Positive And Negative Affect

Healthcare Utilization, Costs, and Adverse Events of Real-Time Continuous Glucose Monitoring (rtCGM) versus Traditional Blood Glucose Monitoring (BG) among US Adults with Type 1 Diabetes

2021 ◽  
pp. 193229682110315
Author(s):  
Benjamin Wong ◽  
Yalin Deng ◽  
Karen L. Rascati
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Adverse Events ◽  
Real Time ◽  
Healthcare Utilization ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Medical Costs ◽  
Blood Glucose Monitoring

Objective: To compare healthcare utilization, costs, and incidence of diabetes-specific adverse events (ie, hyperglycemia, diabetic ketoacidosis, and hypoglycemia) in type 1 diabetes adult patients using real-time continuous glucose monitoring (rtCGM) versus traditional blood glucose monitoring (BG). Methods: Adult patients (≥18 years old) with type 1 diabetes in a large national administrative claims database between 2013 and 2015 were identified. rtCGM patients with 6-month continuous health plan enrollment and ≥1 pharmacy claim for insulin during pre-index and post-index periods were propensity-score matched with BG patients. Healthcare utilization associated with diabetic adverse events were examined. A difference-in-difference (DID) method was used to compare the change in costs between rtCGM and BG cohorts. Results: Six-month medical costs for rtCGM patients ( N = 153) increased from pre- to post-index period, while they decreased for matched BG patients ( N = 153). DID analysis indicated a $2,807 ( P = .062) higher post-index difference in total medical costs for rtCGM patients. Pharmacy costs for both cohorts increased. DID analysis indicated a $1,775 ( P < .001) higher post-index difference in pharmacy costs for rtCGM patients. The incidence of hyperglycemia for both cohorts increased minimally from pre- to post-index period. The incidence of hypoglycemia for rtCGM patients decreased, while it increased marginally for BG patients. Inpatient hospitalizations for rtCGM and BG patients increased and decreased marginally, respectively. Conclusions: rtCGM users had non-significantly higher pre-post differences in medical costs but significantly higher pre-post differences in pharmacy costs (mostly due to the rtCGM costs themselves) compared to BG users. Changes in adverse events were minimal.

The advantages of insulin pump therapy and real time glucose monitoring systems as the tools for reducing the frequency of hypoglycemic episodes in the children and adolescents with type 1 diabetes mellitus

2014 ◽  
Vol 60 (2) ◽  
pp. 24-30 ◽  
Author(s):  
D N Laptev
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Real Time ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy

The primary objective of the present study was to analyse the advantages of insulin pump therapy and real time glucose monitoring systems as the tools for reducing the frequency of hypoglycemic episodes. The study included 190 children and adolescents at the age varying from 1 to 18 years suffering from type 1 diabetes mellitus. All the patients were hospitalized at the Endocrinological Research Centre for the treatment the disease using different modalities of insulin therapy, such as multiple injections of insulin (MII) and its continuous subcutaneous infusion (CSII). The blood glucose level was monitored during 72 hours making use of the continuous blind and real time monitoring protocols (blind-CGM and RT-CGM respectively). All the patients were divided into 4 groups depending on the therapeutic modality and the mode of blood glucose monitoring. Group 1 was comprised of the patients given multiple insulin injections in combination with blind glucose monitoring ("blind-CGM + MII"), group 2 included the patients undergoing blind glucose monitoring in conjunction with continuous insulin infusion ("blind-CGM + CSII"), group 3 contained the patients treated by multiple insulin injections followed by real-time blood glucose monitoring ("RT-CGM + MII"), and group 4 was composed of the patients undergoing continuous subcutaneous infusion of insulin combined with real-time blood glucose monitoring ("RT-CGM + CSII"). In all the cases, the blood glucose levels were measured and the occurrence of hypoglycemia during the period of monitoring time was evaluated. It was shown that the highest frequency of hypoglycemia during 72 hours was recorded in the "blind-CGM" group and the lowest one in the RT-CGM groups. Despite adequate self-control, almost half of the patients in the "blind-CGM + MII" group reported at least one hypoglycemic episode either at the daytime or at night ; the duration of such episode was more than 1 hour on the average. In the "blind-CGM" group, CSII resulted in the decrease of the number of hypoglycemic episodes both at night and daytime (p<0.05). In the "RT-CGM + CSII" group, continuous insulin infusion reduced the mean duration of nocturnal hypoglycemic episodes (p<0.05) whereas this parameter was not significantly different between the other groups. It is concluded that hypoglycemia especially nocturnal one is rather a common problem facing children and adolescents suffering from type 1 diabetes mellitus. The use of insulin pump therapy and real time glucose monitoring systems (RT-CGM) makes it possible to substantially decrease the frequency and duration of hypoglycemic episodes in this population group.

136-OR: Nocturnal Hypoglycemia Prevention Strategies Used by People with Type 1 Diabetes According to Their Insulin Delivery and Blood Glucose Monitoring Technology

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 136-OR
Author(s):  
MERYEM K. TALBO ◽  
VIRGINIE MESSIER ◽  
KATHERINE DESJARDINS ◽  
RÉMI RABASA-LHORET ◽  
ANNE-SOPHIE BRAZEAU ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Blood Glucose Monitoring ◽  
Prevention Strategies ◽  
Monitoring Technology ◽  
Nocturnal Hypoglycemia

scholarly journals Comparison between adherence assessments and blood glucose monitoring measures to predict A1c in type 1 diabetes

2015 ◽  
Vol 7 (S1) ◽  
Author(s):  
Gabriela Heiden Teló ◽  
Martina Schaan de Souza ◽  
Thaís Sturmer Andrade ◽  
Beatriz D'Agord Schaan
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring

scholarly journals Glycemic Control and Blood Glucose Monitoring Over Time in a Sample of Young Australians With Type 1 Diabetes: The role of personality

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 2968-2973 ◽  
Author(s):  
D. Waller ◽  
C. Johnston ◽  
L. Molyneaux ◽  
L. Brown-Singh ◽  
K. Hatherly ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Over Time

scholarly journals Long-term Cost-Effectiveness of Dexcom G6 Real-Time Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Patients With Type 1 Diabetes in the U.K.

2020 ◽  
Author(s):  
Stéphane Roze ◽  
John Isitt ◽  
Jayne Smith-Palmer ◽  
Mehdi Javanbakht ◽  
Peter Lynch
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Cost Effectiveness ◽  
Real Time ◽  
Glucose Monitoring ◽  
Baseline Hba1c ◽  
Self Monitoring ◽  
Quality Adjusted Life

<b>Objective</b> <p>A long-term health economic analysis was performed to establish the cost-effectiveness of real-time continuous glucose monitoring (RT-CGM) (Dexcom G6) versus self-monitoring of blood glucose (SMBG) alone in UK-based patients with type 1 diabetes. </p> <p><b>Methods</b></p> <p>The analysis utilized the IQVIA CORE Diabetes Model. Clinical input data were sourced from the DIAMOND trial in adults with type 1 diabetes; simulations were performed separately in the overall population of patients with baseline HbA1c ≥7.5% (58 mmol/mol); and a secondary analysis was performed in patients with baseline HbA1c ≥8.5% (69 mmol/mol). The analysis was performed from the NHS healthcare payer perspective over a lifetime time horizon. </p> <p><b>Results</b></p> <p>In the overall population, G6 RT-CGM was associated with a mean incremental gain in quality-adjusted life expectancy of 1.49 quality-adjusted life years (QALYs) versus SMBG (mean [standard deviation; SD] 11.47 [2.04] QALYs versus 9.99 [1.84] QALYs). Total mean (SD) lifetime costs were also GBP 14,234 higher with RT-CGM (GBP 102,468 [35,681] versus GBP 88,234 [39,027]) resulting in an ICER of GBP 9,558 per QALY gained. Sensitivity analyses revealed that the findings were sensitive to changes in the quality of life benefit associated with reduced fear of hypoglycemia and avoidance of fingerstick testing as well as the HbA1c benefit associated with RT-CGM use. </p> <p><b>Conclusions</b></p> <p>For UK-based type 1 diabetes patients, the G6 RT-CGM device is associated with significant improvements in clinical outcomes and, over patient lifetimes, is a cost-effective disease management option relative to SMBG, based on a willingness-to-pay threshold of GBP 20,000 per QALY gained. </p>

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