This study compares monitoring costs and perinatal outcomes associated with continuous glucose monitoring (CGM) in addition to blood glucose monitoring (BGM) versus BGM alone when used in pregnant women with type 1 diabetes (T1D). The study was conducted in an Australian healthcare setting to inform decisions to improve access to CGM in this high-risk population.
Outcome data was derived from the CONCEPTT trial 1, an open-label, multicentre, randomised controlled study. Maternal and neonatal length of stay (LOS), caesarean births, pre-term births, and extended (>24 hours) neonatal intensive care (NIC) were compared between CGM and control arms of CONCEPTT. Costs are applied from an Australian healthcare perspective.
CONCEPTT provided strong evidence of neonatal hospitalisation benefits in CGM vs control through reduced neonate length of stay (3.1 vs 4.0; p=0.0091), and a reduced incidence of extended (>24 hours) NIC (0.27 vs 0.43; p=0.0157). Incidence of pre-term births (<37 weeks) was similar (p=0.57) between CGM (38%) and control (42%). CONCEPTT also identified trends in favour of CGM for reduced maternal LOS (3.5 vs 4.2 p=0.1), and reduced incidence of caesarean births, (63% vs 73%; p=0.18).
CGM is subsequently estimated to reduce neonatal hospitalisation costs by $2,105 (CGM: $14,679 vs control: $16,784), and maternal hospitalisation costs by $1,230 (CGM: $8,988 vs control $10,218). The addition of CGM to current standard practice, BGM, is estimated to cost an additional $2,250 in monitoring costs whilst providing savings of $3,335 in maternal and neonate hospitalisation costs.
Evidence from the CONCEPTT trial, applied to an Australian setting, suggests that maternal and neonatal hospitalisation benefits more than offset additional monitoring costs associated with using CGM for the duration of pregnancy in women with T1D. This analysis supports access to CGM for pregnant women with T1D.