Comparing clinical outcomes between two continuous glucose monitors: similar diabetes-related events, all-cause hospitalizations and HbA1c reductions in type 1 and type 2 diabetes

Eden Miller , Gregory J. Roberts , Jennifer M. Joseph , Yelena Nabutovsky , Ignacio J. Reyes , Diana Souto , Naunihal Virdi , Irl B. Hirsch
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Abstract

Objectives

We compared clinical outcomes after acquiring a FreeStyle Libre© Flash Continuous Glucose Monitoring System (FSL) or Dexcom (DEX) continuous glucose monitoring (CGM) device in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) treated with intensive insulin therapy.

Design and Methods

This retrospective analysis of the IBM® MarketScan® Research Databases and IBM® Explorys® Electronic Health Records Database assessed differences in acute diabetes-related events (ADE), all-cause hospitalizations (ACH) and glycated hemoglobin (HbA1c) in T1D and T2D populations 6 months post CGM acquisition. Analyses were conducted in two study cohorts (Cohort 1, n = 7,494; Cohort 2, n = 678). Participants were T1D or T2D, age ≥ 18 years, treated with short or rapid-acting insulin and naïve to CGM, who acquired a CGM system. Users were propensity score matched on demographics and clinical factors.

Results

Cohort 1: Post-CGM ADE-free rates at 6 months ranged from 94.8 to 96.7% and ACH-free rates ranged from 90.4 to 95.4%, for both T1D and T2D groups, with no significant differences between CGM systems. Cohort 2: Significant HbA1c reductions were associated with use of the DEX and FSL devices in the T1D (-0.35% and -0.37%, respectively) and T2D (-0.73% and -0.79%, respectively) cohorts, both p < 0.001, with no significant differences in the magnitude of reduction between systems (T1D p = 0.99 and T2D p = 0.84).

Conclusions

Acquisition of the FSL and DEX systems was associated with similar rates of acute diabetes-related events and all-cause hospitalizations and similar HbA1c reductions in adults with T1D and T2D.

两种连续血糖监测仪的临床结果比较:1型和2型糖尿病的类似糖尿病相关事件、全因住院和HbA1c降低
目的:比较使用FreeStyle Libre©Flash连续血糖监测系统(FSL)或Dexcom (DEX)连续血糖监测(CGM)设备对接受胰岛素强化治疗的1型糖尿病(T1D)和2型糖尿病(T2D)患者的临床结果。设计和方法对IBM®MarketScan®研究数据库和IBM®Explorys®电子健康记录数据库进行回顾性分析,评估T1D和T2D人群在CGM获得6个月后急性糖尿病相关事件(ADE)、全因住院(ACH)和糖化血红蛋白(HbA1c)的差异。对两个研究队列进行分析(队列1,n = 7,494;队列2,n = 678)。参与者为T1D或T2D,年龄≥18岁,接受短效或速效胰岛素治疗,naïve to CGM,获得CGM系统。使用者的倾向评分与人口统计学和临床因素相匹配。结果结果1:CGM后6个月,T1D组和T2D组的ade无症状率为94.8 - 96.7%,ach无症状率为90.4 - 95.4%,CGM系统之间无显著差异。队列2:在T1D(分别为-0.35%和-0.37%)和T2D(分别为-0.73%和-0.79%)队列中,使用DEX和FSL装置可显著降低HbA1c, p <0.001,系统之间的减少幅度无显著差异(T1D p = 0.99, T2D p = 0.84)。结论:获得FSL和DEX系统与T1D和T2D成人急性糖尿病相关事件和全因住院发生率相似,HbA1c降低相似。
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来源期刊
American journal of medicine open
American journal of medicine open Medicine and Dentistry (General)
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