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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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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.
Learn MoreWhile CGM systems were initially prescribed predominantly for patients with T1D, the mounting body of literature and expert recommendations have led to more widespread use in insulin-treated T2D and beyond. Based on RCT and real world evidence supporting CGM use in T2D and published literature demonstrating the utility of CGM in population health, 4 payer and 5 health system experts convened virtually to share their insights on the integration of this technology in current programs. This article provides a review of key evidence discussed by these stakeholders and findings from the meeting, with recommendations for the implementation of T2D population health programs integrating CGM with other interventions.
Learn MoreThis article reports key findings from recent randomized, observational, and retrospective studies investigating use of CGM in type 2 diabetes (T2D) individuals treated with basal insulin only and/or noninsulin therapies. Data from 29 studies were reviewed and analyzed. Both randomized and prospective/retrospective studies have demonstrated significant glycemic improvement, reductions in diabetes-related events and hospitalization rates, and cost benefits of persistent CGM use by individuals with T2D who are treated with basal insulin only, basal plus noninsulin medications, and noninsulin medications without insulin. In 23 (79%) of the 29 studies reviewed, investigators reported associations between CGM and improvements in HbA1c and/or key CGM metrics. These findings, alone, provide strong evidence that supports providing access to this technology to those with T2D who are less intensively treated. The narrative presents an evidence-based rationale for expanded access to CGM within the T2D basal insulin only and/or noninsulin treated population. Recent clinical guidelines from the American Diabetes Association and American Association of Clinical Endocrinology now endorse CGM use in individuals treated with nonintensive insulin regimens. Access in the basal insulin only population has expanded since the start of this project. CGM should be made readily available to all individuals with diabetes who are able to use this technology safely and effectively.
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