TABLE 3

Summary of Emerging Real-World Evidence

Published ReportsDesign/InterventionOutcome MeasuresFindings
A1C reductions 
Miller et al., 2020 (30) • 6- and 12-month retrospective, observational analyses using medical/pharmacy claims database and Quest laboratory A1C values (United States)
• 6- and 12-month: 774 and 207 adults, respectively, with type 2 diabetes treated with long-acting insulin or premixed insulin (n = 277 and 87, respectively) or noninsulin therapy (n = 497 and 120, respectively)
• Acquisition of flash CGM 
• A1C • A1C decreased by −0.8% (P <0.0001) in the 6-month cohort: long-acting insulin by −0.6% (P <0.0001), noninsulin by −0.9% (P <0.0001).
• A1C decreased by −0.6% (P <0.0001) in the 12-month cohort: long-acting insulin by −0.5% (P = 0.0014), noninsulin by −0.7% (P <0.0001). 
Wright et al., 2020 (31) • 12-month, retrospective, observational study using IBM Explorys, a U.S. EHR database
• 1,183 adults with type 2 diabetes using long-acting insulin or premixed insulin (n = 378) or noninsulin (n = 805) therapy
• 12-month, retrospective, observational study using IBM Explorys, a U.S. EHR database 
• A1C • A1C decreased by −1.38% (from 10.16 to 8.78%, P <0.0001) at 6 months post–flash CGM acquisition.
• Greatest reductions of A1C were seen in participants with highest baseline A1C levels. 
Eeg-Olofsson et al., 2020 (48) • 12-month, retrospective, observational study using Swedish National Diabetes Register
• 538 adults with type 1 or type 2 diabetes
• Flash CGM use 
• A1C • A1C decreased by −0.52% (P <0.0001) at 12 months. 
Reductions in events/hospitalizations 
Hirsch et al., 2020 (37) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 12,521 adults with type 1 or type 2 diabetes
• Acquisition of flash CGM 
• Acute ADEs for hypoglycemia or hyperglycemia • ADE decreased from 0.245 to 0.132 events/patient-year (HR: 0.54 [95% CI 0.49–0.59], P <0.001).
• Similar reductions in ADE were seen in participants with a history of performing four or more or less than four glucose tests per day. 
Bergenstal et al., 2020 (35) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 1,244 adults with type 2 diabetes
• Acquisition of flash CGM 
• Acute ADEs for hypoglycemia or hyperglycemia
• ACH 
• ADEs decreased from 0.158 to 0.077 events/patient-year (HR: 0.49 [95% CI 0.34–0.69], P <0.001).
• ACH decreased from 0.345 to 0.247 events/patient-year (HR: 0.72 [95% CI 0.58–0.88], P = 0.002). 
Miller et al., 2020 (33) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 7,167 adults with type 2 diabetes treated with long-acting insulin or noninsulin therapy
• Acquisition of flash CGM 
• Acute ADEs
• Hospitalization or outpatient emergency for hypoglycemia or hyperglycemia 
• ADEs decreased at 6 months post-acquisition of flash CGM from 0.071 to 0.052 events/patient-year (HR: 0.70 [95% CI 0.57–0.85], P <0.001).
• Hospitalizations decreased from 0.180 to 0.161 events/patient-year (HR: 0.87 [95% CI 0.78–0.98], P = 0.025). 
Roussel et al., 2020 (34) • 12-month, retrospective, observational study using the French nationwide reimbursement claims database
• 33,203 individuals with type 1 diabetes and 40,955 individuals with type 2 diabetes
• Flash CGM use for 12 months 
• Hospitalizations for DKA • DKA hospitalizations decreased by 52% in participants with type 1 diabetes and by 47% in those with type 2 diabetes. 
Published ReportsDesign/InterventionOutcome MeasuresFindings
A1C reductions 
Miller et al., 2020 (30) • 6- and 12-month retrospective, observational analyses using medical/pharmacy claims database and Quest laboratory A1C values (United States)
• 6- and 12-month: 774 and 207 adults, respectively, with type 2 diabetes treated with long-acting insulin or premixed insulin (n = 277 and 87, respectively) or noninsulin therapy (n = 497 and 120, respectively)
• Acquisition of flash CGM 
• A1C • A1C decreased by −0.8% (P <0.0001) in the 6-month cohort: long-acting insulin by −0.6% (P <0.0001), noninsulin by −0.9% (P <0.0001).
• A1C decreased by −0.6% (P <0.0001) in the 12-month cohort: long-acting insulin by −0.5% (P = 0.0014), noninsulin by −0.7% (P <0.0001). 
Wright et al., 2020 (31) • 12-month, retrospective, observational study using IBM Explorys, a U.S. EHR database
• 1,183 adults with type 2 diabetes using long-acting insulin or premixed insulin (n = 378) or noninsulin (n = 805) therapy
• 12-month, retrospective, observational study using IBM Explorys, a U.S. EHR database 
• A1C • A1C decreased by −1.38% (from 10.16 to 8.78%, P <0.0001) at 6 months post–flash CGM acquisition.
• Greatest reductions of A1C were seen in participants with highest baseline A1C levels. 
Eeg-Olofsson et al., 2020 (48) • 12-month, retrospective, observational study using Swedish National Diabetes Register
• 538 adults with type 1 or type 2 diabetes
• Flash CGM use 
• A1C • A1C decreased by −0.52% (P <0.0001) at 12 months. 
Reductions in events/hospitalizations 
Hirsch et al., 2020 (37) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 12,521 adults with type 1 or type 2 diabetes
• Acquisition of flash CGM 
• Acute ADEs for hypoglycemia or hyperglycemia • ADE decreased from 0.245 to 0.132 events/patient-year (HR: 0.54 [95% CI 0.49–0.59], P <0.001).
• Similar reductions in ADE were seen in participants with a history of performing four or more or less than four glucose tests per day. 
Bergenstal et al., 2020 (35) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 1,244 adults with type 2 diabetes
• Acquisition of flash CGM 
• Acute ADEs for hypoglycemia or hyperglycemia
• ACH 
• ADEs decreased from 0.158 to 0.077 events/patient-year (HR: 0.49 [95% CI 0.34–0.69], P <0.001).
• ACH decreased from 0.345 to 0.247 events/patient-year (HR: 0.72 [95% CI 0.58–0.88], P = 0.002). 
Miller et al., 2020 (33) • 12-month, retrospective, observational study using IBM MarketScan Commercial Claims and Medicare Supplemental databases
• 7,167 adults with type 2 diabetes treated with long-acting insulin or noninsulin therapy
• Acquisition of flash CGM 
• Acute ADEs
• Hospitalization or outpatient emergency for hypoglycemia or hyperglycemia 
• ADEs decreased at 6 months post-acquisition of flash CGM from 0.071 to 0.052 events/patient-year (HR: 0.70 [95% CI 0.57–0.85], P <0.001).
• Hospitalizations decreased from 0.180 to 0.161 events/patient-year (HR: 0.87 [95% CI 0.78–0.98], P = 0.025). 
Roussel et al., 2020 (34) • 12-month, retrospective, observational study using the French nationwide reimbursement claims database
• 33,203 individuals with type 1 diabetes and 40,955 individuals with type 2 diabetes
• Flash CGM use for 12 months 
• Hospitalizations for DKA • DKA hospitalizations decreased by 52% in participants with type 1 diabetes and by 47% in those with type 2 diabetes. 

EHR, electronic health record; IBM, International Business Machines.

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