LONG-TERM OUTCOMES OF BELGIAN REAL-TIME CONTINUOUS GLUCOSE MONITORING REIMBURSEMENT FOR ADULTS WITH TYPE 1 DIABETES ON INSULIN PUMP THERAPY: RESULTS AFTER 24 MONTHS RESCUE STUDY

Abstract

Background and Aims: Long‐term real‐world studies on the use of glucose sensors are scarce. This study evaluates the impact of real‐time continuous glucose monitoring (RT‐CGM) reimbursement in adults with type 1 diabetes (T1D) who use continuous subcutaneous insulin infusion (CSII) in Belgium.

Methods: Data from this 24‐month, prospective, real‐world study were collected between September 2014 and December 2018. Main endpoints were evolution of HbA1c, hospitalisations for hypoglycaemia and ketoacidosis, quality of life, and time in ranges. Data are mean (95% CI).

Results: Of 515 people, 82 (16%) stopped using RT‐CGM, mainly because of alarm fatigue (n = 27). Baseline HbA1c decreased from 7.7% (7.5–7.8) to 7.4% (7.2–7.5) at 12 months and remained stable for 24 months (p < 0.001 for both). In participants with baseline HbA1c >8.0%, HbA1c dropped from 8.8% (8.6–8.9) to 8.1% (7.9–8.2) at 24 months (p < 0.001), while it increased from 6.5% (6.4–6.6) to 6.7% (6.5–6.8) (p < 0.001) in participants with baseline HbA1c <7.0%. One year before reimbursement, 15% of participants were hospitalised for hypoglycaemia or ketoacidosis in contrast to 4% in year 1 and 3% in year 2 (p < 0.001 for both). The worry subscale of the Hypoglycaemia Fear Survey improved (18.2 [16.8–19.5] at baseline; 14.0 [12.6–15.3] after 24 months; p < 0.001). Time <54 mg/dL and <70‐≥54 mg/dL significantly decreased from 1.2% (1.0–1.4) and 3.7% (3.3–4.2) in the first two weeks to respectively 0.9% (0.7–1.0) and 2.8% (2.4–3.2) after 24 months (p < 0.001).

Conclusions: RT‐CGM reimbursement for adults with T1D on CSII results in improved glycaemic control and quality of life, with fewer diabetes‐related hospitalisations, which is sustained over 24 months.