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Title: A systematic review: Cost-effectiveness of continuous glucose monitoring compared to self-monitoring of blood glucose in type 1 diabetes.
Austin Authors: Jiao, Yuxin;Lin, Rose;Hua, Xinyang;Churilov, Leonid ;Gaca, Michele J;James, Steven;Clarke, Philip M;O'Neal, David;Ekinci, Elif I 
Affiliation: Austin Health
Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia.
Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
Austin Health Sciences Library
School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Queensland, Australia.
Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Department of Medicine, St Vincent's Hospital Melbourne, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
General Medicine
Issue Date: Sep-2022
Date: 2022
Publication information: Endocrinology, Diabetes and Metabolism 2022
Abstract: Continuous glucose monitoring (CGM) is rapidly becoming a vital tool in the management of type 1 diabetes. Its use has been shown to improve glycaemic management and reduce the risk of hypoglycaemic events. The cost of CGM remains a barrier to its widespread application. We aimed to identify and synthesize evidence about the cost-effectiveness of utilizing CGM in patients with type 1 diabetes. Studies were identified from MEDLINE, Embase and Cochrane Library from January 2010 to February 2022. Those that assessed the cost-effectiveness of CGM compared to self-monitored blood glucose (SMBG) in patients with type 1 diabetes and reported lifetime incremental cost-effectiveness ratio (ICER) were included. Studies on critically ill or pregnant patients were excluded. Nineteen studies were identified. Most studies compared continuous subcutaneous insulin infusion and SMBG to a sensor-augmented pump (SAP). The estimated ICER range was [$18,734-$99,941] and the quality-adjusted life year (QALY) gain range was [0.76-2.99]. Use in patients with suboptimal management or greater hypoglycaemic risk revealed more homogenous results and lower ICERs. Limited studies assessed CGM in the context of multiple daily injections (MDI) (n = 4), MDI and SMBG versus SAP (n = 2) and three studies included hybrid closed-loop systems. Most studies (n = 17) concluded that CGM is a cost-effective tool. This systematic review suggests that CGM appears to be a cost-effective tool for individuals with type 1 diabetes. Cost-effectiveness is driven by reducing short- and long-term complications. Use in patients with suboptimal management or at risk of severe hypoglycaemia is most cost-effective.
DOI: 10.1002/edm2.369
ORCID: 0000-0001-7580-3623
Journal: Endocrinology, Diabetes and Metabolism
Start page: e369
PubMed URL: 36112608
ISSN: 2398-9238
Type: Journal Article
Subjects: continuous glucose monitoring
health economics
self-monitoring blood glucose
type 1 diabetes
Diabetes Mellitus, Type 1/drug therapy
Blood Glucose Self-Monitoring/methods
Appears in Collections:Journal articles

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