660-P: The Effect of Real-Time Continuous Glucose Monitors on Fear of Hypoglycemia in People with Type 1 Diabetes: A Systematic Review and Meta-analysis

TALBO, MERYEM K.; KATZ, ALEXANDRA; PETERS, TRICIA; Yale, Jean‐François; WU, ZEKAI; BRAZEAU, ANNE-SOPHIE

doi:10.2337/db22-660-p

Cited by 3 publications

(2 citation statements)

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“…Importantly, diabetes technologies, including CGM, may partially address fear of hypoglycaemia, but studies focusing on fear as a primary outcome are lacking and the majority of the impact seen is in the domain of worry, rather than addressing behaviours. 27 The increasing visibility of glucose data, trends and alerts are useful tools to reduce uncertainty and have been shown to be associated with improved emotional wellbeing for users, including those suffering high fear of hypoglycaemia. The amount of data, however, has also been shown to be overwhelming for many and is a major contributing factor to the cessation of use of such devices.…”

Section: Implications Of This Researchmentioning

confidence: 99%

“…Studies analysing its association with levels of HbA1c showed conflicting results. Importantly, diabetes technologies, including CGM, may partially address fear of hypoglycaemia, but studies focusing on fear as a primary outcome are lacking and the majority of the impact seen is in the domain of worry, rather than addressing behaviours 27 …”

Section: Unmet Needs/pain Points For Cgm Developmentmentioning

confidence: 99%

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Identifying the deficiencies of currently available CGM to improve uptake and benefit

Barnard‐Kelly,

Martínez‐Brocca,

Glatzer

et al. 2024

Diabet Med

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Background and AimsThe use of diabetes technologies is increasing worldwide, with health systems facilitating improved access to devices. Continuous glucose monitoring is a complex intervention that provides information on glucose concentration, rate and direction of change, historical data and alerts and alarms for extremes of glucose. These data do not themselves change glycaemia and require translation to a meaningful action for impact. It is, therefore, crucial that such systems advance to better meet the needs of individuals using them.MethodsNarrative review of the use of, engagement with, limitations and unmet needs of continuous glucose monitoring systems.ResultsCGM devices have made a significant contribution to the self‐management of diabetes; however, challenges with access and user experience persist, with multiple limitations to uptake and benefit. These limitations include physical size and implementation, with associated stigma, alarm fatigue, sleep disturbance and the challenge of addressing large volumes of real‐time data. Greater personalisation throughout the continuous glucose monitoring journey, with a focus on usability, may improve the benefits derived from the device and reduce the burden of self‐management. Healthcare professionals may have unconscious biases that affect the provision of continuous glucose monitors due to deprivation, education, age, ethnicity and other characteristics.ConclusionsContinuous glucose monitoring exerts a dose‐dependent response; the more it is used, the more effective it is. For optimal use, continuous glucose monitors must not just reduce the burden of management in one dimension but facilitate net improvement in all domains of self‐management for all users.

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Section: Implications Of This Researchmentioning

confidence: 99%

Section: Unmet Needs/pain Points For Cgm Developmentmentioning

confidence: 99%

Identifying the deficiencies of currently available CGM to improve uptake and benefit

Barnard‐Kelly,

Martínez‐Brocca,

Glatzer

et al. 2024

Diabet Med

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Exploring Technology’s Influence on Health Behaviours and Well-being in Type 1 Diabetes: a Review

McClure,

Talbo,

Bonhoure

et al. 2024

Curr Diab Rep

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Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type 2 diabetes in Canada

Alshannaq,

Isitt,

Pollock

et al. 2023

J. Comp. Eff. Res.

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Aim: Clinical trials and real-world data for Type 2 diabetes have shown that real-time continuous glucose monitoring (rt-CGM) lowers glycated hemoglobin (A1c) and reduces hypoglycemia relative to self-monitoring of blood glucose (SMBG). This analysis examined the long-term health and economic outcomes associated with using rt-CGM versus SMBG in people with insulin-treated Type 2 diabetes in Canada. Materials & methods: Clinical data were sourced from a real-world study, in which rt-CGM reduced A1C by 0.56% versus continued SMBG. The analysis was performed using the IQVIA Core Diabetes Model, from a Canadian payer perspective over a lifetime horizon for a cohort aged 65 years with an A1C of 8.3% at baseline. Future costs and clinical outcomes were discounted at 1.5% annually. Results: Projected total mean lifetime costs were CAD 207,466 for rt-CGM versus CAD 189,863 for SMBG (difference: CAD 17,602) and projected mean quality-adjusted life expectancy was 9.97 quality-adjusted life years (QALYs) for rt-CGM versus 9.02 QALYs for SMBG (difference: 0.95 QALYs), resulting in an incremental cost-utility ratio (ICUR) of CAD 18,523 per QALY gained for rt-CGM versus SMBG. Findings were sensitive to changes in the A1C treatment effect, annual cost and quality of life benefit associated with using rt-CGM, SMBG frequency, and baseline age, but ICURs remained below CAD 50,000 per QALY in all analyses. Conclusion: For people in Canada with insulin-treated Type 2 diabetes and poor glycemic control, use of rt-CGM is likely to be cost-effective relative to SMBG.

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660-P: The Effect of Real-Time Continuous Glucose Monitors on Fear of Hypoglycemia in People with Type 1 Diabetes: A Systematic Review and Meta-analysis

Cited by 3 publications

References 0 publications

Identifying the deficiencies of currently available CGM to improve uptake and benefit

Identifying the deficiencies of currently available CGM to improve uptake and benefit

Exploring Technology’s Influence on Health Behaviours and Well-being in Type 1 Diabetes: a Review

Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose in people with insulin-treated Type 2 diabetes in Canada

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