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If you’ve thought about switching to a continuous glucose monitor (CGM) to watch your glucose levels, the high price may have stopped you. But recent research suggests CGMs may pay off in greater health benefits—and might even lower your health costs in the long run.
After a six-month trial, investigators at the University of Chicago Medicine found that people with type 1 diabetes who used a CGM had improved blood sugar control and fewer episodes of low blood sugar compared to people who relied on a glucose meter and test strips.
Projecting these findings over a simulated lifetime showed that CGM users could expect a rosy future, with benefits for both their health and their wallet.
“If you map out the lifetime of a patient, it's impressive. The CGM adds years of life and years of quality life,” said Elbert Huang, MD, senior author of the study, in a news release. “While it does cost additional money, the costs saved by lower risk of complications offsets the upfront costs.”
Why a CGM is better
A glucose meter can only tell you what your blood sugar levels are at the moment when you test. A CGM provides nearly continuous information from a tiny sensor inserted under your skin. You can see your current glucose levels anytime without drawing blood. CGMs can also show you whether your glucose is currently rising or falling, to help prevent dangerous highs or lows. And you can identify trends in how your body reacts to food, physical activity, and medicine to help you keep your glucose levels where you want them.
Having a CGM doesn’t mean you can throw away your meter, though. CGM instructions tell you to test with a meter to confirm low blood sugar or a need to take insulin. And most CGMs require you to calibrate them every day by comparing their reading to a finger-prick test.
Researchers studied 158 adults with type 1 diabetes who inject insulin every day. They divided the subjects into two groups: one used CGMs and the other tested with finger pricks. Compared to the finger-prick group, CGM users saw improvements in HbA1c levels (which show their average glucose levels in recent months) and had fewer non-severe low blood sugar episodes.
Next, the researchers used a sort of high-tech “crystal ball” to peer into the future. A statistical model calculated how many years people in each group could expect to live a high quality of life free from diabetes complications. They concluded that using a CGM could add more than six months of good health to your life and reduce your lifetime risk of complications.
“Basically, all the CGM does is provide information, but that allows patients to change the way they eat or time their medications,” said Huang. “It empowers patients to manage their own health.”
CGMs cost more to buy and use than meters and test strips. The CGM chosen for this study costs $2,500, though some other models cost much less. There is also the continuing expense of the CGM sensor, which must be replaced after several days. For the six-month study, health costs totaled $11,032 per person in the CGM group and $7,236 for the finger-stick group.
Researchers believe that the lifetime health benefits of CGMs show that they are cost-effective for health insurers to cover. But everyone’s health insurance is different, and yours may not cover CGMs. Even if it does, some insurers have complicated requirements. Ask ahead of time what is covered and make sure you understand exactly what you have to do for your claim to be paid.
Should you switch to a CGM? That’s a decision to think carefully about—and an important conversation to have with your doctor, who can explain the pros and cons in your individual circumstances.
This study was partly supported by a grant from Dexcom, a CGM manufacturer. Image courtesy of University of Chicago Medicine.
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