GSB 7.1 Standardlösung

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Continuous glucose monitoring

Continuous glucose monitoring (CGM) is a minimally invasive method of measuring sugar levels in the interstitial fluid of the subcutaneous tissue. A glucose sensor is used to take either continuous (real-time CGM systems; rtCGM) or intermittent (flash glucose monitoring, FGM, intermittent glucose monitoring; iscCGM) measures that are then transmitted to a receiving device. CGM makes it possible to measure sugar levels without the need for blood samples and is particularly useful for children and adolescents with type 1 diabetes (AGPD, 2015, DDG, 2018). Since 2016, the costs of CGM devices have been covered by statutory health insurers (G-BA, 2016).

Key messages

  • More than two thirds of children and adolescents with type 1 diabetes in Germany use continuous glucose monitoring.
  • No differences were identified between the sexes in the use of continuous glucose monitoring.
  • The reimbursement of costs by statutory health insurers and the availability of new, user-friendly devices have played a decisive role in the rapid increase in CGM use.

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Results

In 2019, the prevalence of CGM use in children and adolescents aged 0 to 17 years with type 1 diabetes was 69.3% (girls: 69.5%; boys: 69.2%). Between 2007 and 2015, the prevalence of CGM use was low (from 3.2% to 6.4%) and takeup even slowed down slightly. Since 2016, however, CGM use has increased rapidly. In 2016, the prevalence of CGM use (18.2%) was more than 4 times higher than in the previous year (4.0%). Hardly any differences between the sexes were identified for CGM use over the entire 2007 to 2019 observation period.

Conclusion

About 70% of children and adolescents with type 1 diabetes in Germany currently use continuous glucose monitoring (CGM). CGM use has been increasing rapidly since 2016. It is assumed that the reimbursement of CGM costs by statutory health insurers, which was introduced in 2016 (G-BA, 2016), has played a decisive role in the rapid increase in CGM use. Besides, new, user-friendly devices are developed and available, this may also play a role. CGM aims to stablise blood sugar levels, and, in particular, prevent hypoglycaemia (Kamusheva et al., 2021). However, more research is needed into the impact of CGM use on glucose control and the safety of therapy in children and adolescents.

Show more information on methodology and data sources

Definition

The indicator continuous glucose monitoring (CGM) is defined as the proportion of children and adolescents with type 1 diabetes who use continuous glucose monitoring.

Reference population

Children and adolescents aged between 0 and 17 years who are resident in Germany.

Data Sources

Nationwide and regional diabetes registers (DPV register, ESPED incidence register, North-Rhein Westphalia register, Saxony diabetes register). The data are based on the September 2020 data set from the DPV database, which has been fully validated and committed to the database.

Calculation

  • Description: The rate of continuous glucose monitoring use related to children and adolescents aged 0-17 years with type 1 diabetes in Germany during the 2007-2019 observation period.
  • Extrapolation/weighting: the population data gathered by the Federal Statistical Office during the 2011 census were used for the nationwide estimates. Results with 95% confidence intervals were estimated using the person-years method. A Poisson distribution of cases was assumed (Woodward 2013; Sahai 1993).
  • Age standardisation: Estimates were standardised by age and sex and were equally weighted for the age groups under consideration.

Data quality of the participating practices

The diabetes registries provide outpatient or inpatient diagnostic data and information on the type of therapy provided to people with statutory and private health insurance. This includes information about people with different types of diabetes and age groups. These data are provided by practices and clinics participating on a voluntary basis. The data quality depends on the practice providing the data. All documentation is subject to a thorough plausibility check. Statistical methods are used for extrapolation and to ensure full coverage of the reference population.