January 29, 2021
Clinical Outcomes
Guidelines / Policy

Source: National Institute for Health and Care Excellence (NICE) Guideline – Diabetes in Pregnancy: Management from Preconception to the Postnatal Period (2020)

Key Takeaway: In December 2020, NICE reviewed the evidence and changed the recommendations on intermittently scanned CGM (isCGM, also commonly referred to as flash) and continuous glucose monitoring during pregnancy for women with type 1 diabetes.

Recommendations for Managing Diabetes During Pregnancy-Intermittently scanned CGM and continuous glucose monitoring

1.3.17Offer continuous glucose monitoring (CGM) to all pregnant women with type 1 diabetes to help them meet their pregnancy blood glucose targets and improve neonatal outcomes. 
1.3.18Offer intermittently scanned CGM (isCGM, commonly referred to as flash) to pregnant women with type 1 diabetes who are unable to use continuous glucose monitoring or express a clear preference for it. 
1.3.19Consider continuous glucose monitoring for pregnant women who are on insulin therapy but do not have type 1 diabetes, if they have problematic severe hypoglycaemia (with or without impaired awareness of hypoglycaemia) or they have unstable blood glucose levels that are causing concern despite efforts to optimise glycaemic control.
1.3.20For pregnant women who are using isCGM or continuous glucose monitoring, a member of the joint diabetes and antenatal care team with expertise in these systems should provide education and support (including advising women about sources of out-of-hours support).

For a short explanation of why the committee made the 2020 recommendations and how they might affect practice, see the rationale and impact section on flash and continuous glucose monitoring on pages 35-36 in the Guideline. Full details of the evidence and the committee’s discussion are in evidence review A: continuous glucose monitoring.

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January 11, 2021
Coverage and Benefit Design
Population Health
Webinar / Archive

Presented by:
Daniel DeSalvo, MD
Assistant Professor of Pediatrics in the Section of Diabetes and Endocrinology
Baylor College of Medicine/Texas Children’s Hospital
Houston TX

In diverse and underserved populations research shows there are racial and ethnic disparities in diabetes outcomes. Disparities in diabetes technology use has the greatest influence on glycemic disparities between Black, Hispanic and Non-Hispanic White individuals. A study recently published in Diabetes Care found that lower socio-economic status was associated with lower rates of diabetes technology use and higher levels of A1C. Importantly, this gap in technology has widened over time.  Data published from the T1D exchange, shows that across all age groups, individuals that use continuous glucose monitoring (CGM) have lower A1C levels compared to those who don’t use CGM.

This webinar will highlight the improvements in glycemic and psychosocial outcomes, along with best practices from recent research findings that support the use of CGM in diverse populations.

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December 22, 2020
Population Health
CGM Best Practices / Interview

Expert: (Formerly) Vice President Clinical Strategy and Programs and Industry Relations, MagellanRx Management (Currently Chief Clinical Officer, Cooperative Benefits Group)

Summary: In this video interview Dr. Dunn discusses best practices and considerations for payers when they consider moving CGM coverage to the pharmacy benefit, application of utilization management, and more.

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December 8, 2020
CGM Technology and Digital Health
Clinical Outcomes
Economic Outcomes
Webinar / Archive

Source: AMCP Science and Innovation Theater Webinar – November 17, 2020

Key Takeaway: Advances in the Dexcom G6 technology are an important CGM differentiator that allows for improved safety, glycemic management and telehealth opportunities for persons 2 years and older through the use of real-time CGM data with features such as a predictive Urgent Low Soon alert, customizable high/low glycemic threshold alerts, remote monitoring and the CLARITY diabetes management application.

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November 3, 2020
Economic Outcomes
Article / Publication / CGM Innovations

Source:

Key Takeaway: The intended place in therapy is as an alternative to routine blood glucose monitoring in people (over 2 years old), including pregnant women, with type 1 or type 2 diabetes, who use multiple daily insulin injections or use insulin pumps and are self-managing their diabetes.  Dexcom G6 could reduce costs and would benefit the healthcare system by improving long-term outcomes, reducing the need for intensive treatment and, in the short term, reducing severe hypoglycaemic events leading to hospital admissions. Remote care may reduce the need for hospital visits.

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October 8, 2020
Clinical Outcomes
Article / Publication

Source:

Key Takeaway: Real-world data from the German/Austrian Prospective Diabetes Follow-Up Registry showed real-time continuous glucose monitoring was associated with a higher percentage of Time-in-Range and improved metabolic stability as compared to intermittent scanning continuous glucose monitoring.

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October 8, 2020
Clinical Outcomes
Article / Publication

Source:

Key Takeaway: A recent systematic review and meta-analysis of 15 randomized controlled trials involving 2,461 patients showed greater improvement in mean hemoglobin A1c, time in target range, and time above range with use of real-time continuous glucose monitoring as compared to intermittently scanned continuous glucose monitoring.

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October 8, 2020
Clinical Outcomes
Coverage and Benefit Design
Article / Publication

Source:

Key Takeaway: In a Medicaid population of youth with Type 1 Diabetes, uninterrupted continuous glucose monitoring (CGM) use was associated with improvements in hemoglobin A1c. Interruptions in use—primarily due to gaps in insurance coverage of CGM—were associated with increased hemoglobin A1c, supporting initial and ongoing CGM coverage in high-risk, publicly insured demographics.

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September 24, 2020
Clinical Outcomes
Economic Outcomes
Article / Publication

Source:

Key Takeaway:  Recent data from a prospective, randomized study conducted by Intermountain Health suggests that real-time CGM can reduce healthcare utilization and decrease the overall cost of care compared to SMBG. Participants reported that real-time CGM data were helpful in modifying their nutrition, physical activity, stress, and medication adherence.

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September 1, 2020
Clinical Outcomes
Article / Publication

Source:

Key Takeaway: In a 16-week trial funded by the NIDDK and Tandem Diabetes Care, 101 children ages 6-13 with type 1 diabetes were randomized to a closed-loop system of insulin delivery (n=78) or the control group (n=23) where patients used a sensor-augmented insulin pump.  Children using the closed-loop system, consisting of a t:slim X2 insulin pump with Control-IQ  technology and a Dexcom G6 CGM, saw a significant time in range (TIR) improvement (target 70-180 mg/dL) from 53% at baseline to 67% (equivalent to 3.4 more hours per day; p<0.001) at the end of the study.  The control group saw a smaller TIR increase from 51% at baseline to 55% at the end of the study.  Notably, TIR increased most significantly overnight with children reaching 80% overnight TIR compared to 54% in the control group.  The treatment effect was evident in the first month and appeared consistent over 4 months.  Control-IQ technology demonstrated benefits across a broad range of baseline characteristics and proved easy to use for children and their parents.

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