RtCGM Use is Associated with Improved Glycemic Control Compared to isCGM in Commercially Insured People with Type 2 Diabetes on Semaglutide and Insulin
Author(s)
Poorva Nemlekar, MS, Katia Hannah, BS, MPH, PhD, Blake C. Liu, MSc, Greg Norman, PhD;
Dexcom, HEOR, Global Access, San Diego, CA, USA
Dexcom, HEOR, Global Access, San Diego, CA, USA
Presentation Documents
OBJECTIVES: Previous research indicates adding glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to an insulin therapy improves glycemic control in people with type 2 diabetes (PwT2D). Additionally, continuous glucose monitoring (CGM) systems, in conjugation with anti-diabetes medications, offer supplementary options to enhance diabetes care. This study evaluated if glycemic outcomes differ between CGM systems (intermittently scanned CGM [isCGM] or real-time CGM [rtCGM]) in PwT2D using insulin (basal and/or bolus) and a GLP-1 RA (semaglutide).
METHODS: Retrospective analysis of de-identified US healthcare claims data from Optum’s Clinformatics® database was conducted. CGM-naïve adults (age ≥30 years) with type 2 diabetes using insulin and semaglutide were identified. Index date was first claim for rtCGM (Dexcom G-series) or isCGM (Freestyle Libre, 14-day, Libre 2) between 01/01/2019 through 06/30/2023. Continuous health plan enrollment of 6-months pre- (baseline) and post-(follow-up) index date was required for inclusion. Individuals with evidence of pregnancy were excluded. At least one laboratory HbA1c value was required during baseline and follow-up to calculate the HbA1c change. Multivariate linear regression was used to regress HbA1c change by CGM type controlling for covariates: age, gender, baseline HbA1c, comorbidity, race and region.
RESULTS: A total of 444 PwT2D taking insulin and semaglutide (rtCGM users, n=205; isCGM users, n=239) with commercial insurance were identified. Participants in both cohorts were approximately 55 years, 29.6-31.7% non-White and 55.1-61.1% male. Overall, a significantly greater HbA1c reduction was observed in the rtCGM cohort compared to the isCGM cohort (difference-in-differences: -0.43%, p=0.042). After adjusting for covariates, rt-CGM use was associated with a -0.31% (p=0.007) greater reduction in HbA1c compared to isCGM use.
CONCLUSIONS: RtCGM use was associated with significantly greater reductions in HbA1c compared to isCGM use. These findings suggest rtCGM use among PwT2D taking both insulin and a GLP-1 RA (semaglutide) can be beneficial and potentially improve glycemic outcomes.
METHODS: Retrospective analysis of de-identified US healthcare claims data from Optum’s Clinformatics® database was conducted. CGM-naïve adults (age ≥30 years) with type 2 diabetes using insulin and semaglutide were identified. Index date was first claim for rtCGM (Dexcom G-series) or isCGM (Freestyle Libre, 14-day, Libre 2) between 01/01/2019 through 06/30/2023. Continuous health plan enrollment of 6-months pre- (baseline) and post-(follow-up) index date was required for inclusion. Individuals with evidence of pregnancy were excluded. At least one laboratory HbA1c value was required during baseline and follow-up to calculate the HbA1c change. Multivariate linear regression was used to regress HbA1c change by CGM type controlling for covariates: age, gender, baseline HbA1c, comorbidity, race and region.
RESULTS: A total of 444 PwT2D taking insulin and semaglutide (rtCGM users, n=205; isCGM users, n=239) with commercial insurance were identified. Participants in both cohorts were approximately 55 years, 29.6-31.7% non-White and 55.1-61.1% male. Overall, a significantly greater HbA1c reduction was observed in the rtCGM cohort compared to the isCGM cohort (difference-in-differences: -0.43%, p=0.042). After adjusting for covariates, rt-CGM use was associated with a -0.31% (p=0.007) greater reduction in HbA1c compared to isCGM use.
CONCLUSIONS: RtCGM use was associated with significantly greater reductions in HbA1c compared to isCGM use. These findings suggest rtCGM use among PwT2D taking both insulin and a GLP-1 RA (semaglutide) can be beneficial and potentially improve glycemic outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
MT15
Topic
Medical Technologies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)