The following is a summary of “Continuous glucose monitoring vs. self-monitoring in pregnant individuals with type 1 diabetes: an economic analysis,” published in the June 2024 issue of Obstetrics & Gynecology by DIAB et al.

In the United States, approximately 1% of pregnancies are complicated by pregestational diabetes, posing heightened risks for adverse maternal and neonatal outcomes, particularly among individuals with type 1 diabetes. Continuous glucose monitoring (CGM) has emerged as a beneficial technology in managing diabetes, albeit at a higher cost than traditional intermittent fingerstick monitoring, mainly when utilized exclusively during pregnancy.

This study aimed to conduct an in-depth economic analysis comparing the costs associated with continuous glucose monitoring versus self-monitoring of blood glucose in a cohort of pregnant individuals diagnosed with type 1 diabetes mellitus.

Researchers constructed an economic model to evaluate two monitoring strategies during pregnancy: continuous glucose monitoring and self-monitoring. The analysis incorporated outcomes such as hypertensive disorders of pregnancy, the incidence of large for gestational-age infants, rates of cesarean delivery, neonatal intensive care unit (NICU) admissions, and occurrences of neonatal hypoglycemia. The primary endpoint was the total cost per strategy from the health system’s perspective in 2022 USD, with self-monitoring as the comparator. The study group derived probabilities, relative risks, and costs from existing literature, adjusting figures to reflect current monetary values. Sensitivity analyses were performed by varying parameters based on probability distributions, relative risks, and cost data, with results validated through 1000 Monte Carlo simulations.

In the base-case scenario, the total cost of pregnancy care using continuous glucose monitoring amounted to $26,837 per individual, compared to $29,039 for those utilizing self-monitoring, translating to a cost savings of $2,202 per person with continuous glucose monitoring. Key parameters influencing incremental costs included the relative risk associated with NICU admissions, costs related to NICU stays, expenses associated with continuous glucose monitoring, and standard care costs. Monte Carlo simulations underscored continuous glucose monitoring as the superior strategy in 98.7% of iterations. One-way sensitivity analysis indicated continuous glucose monitoring’s economic advantage when the relative risk of NICU admission with CGM versus self-monitoring remained below 1.15.

The findings suggest that continuous glucose monitoring is more cost-effective than self-monitoring for managing type 1 diabetes during pregnancy. This economic evaluation underscores the potential financial benefits of adopting CGM technology in prenatal care settings, facilitating improved maternal and neonatal health outcomes among this high-risk population.

Source: sciencedirect.com/science/article/abs/pii/S2589933324001393