A recent study has shown that use of continuous glucose monitoring (CGM) during pregnancy will save NHS England around £9.5 million per year.
Earlier this year, following pressure from JDRF and other type 1 diabetes campaigners, we announced that CGM will be available on the NHS for all pregnant women in England with type 1 diabetes, as its use is beneficial to the health of both mother and baby. The current study shows that, if used for the entire pregnancy alongside self-monitoring of blood glucose, CGM use can save NHS England around £9.5 million compared to self-monitoring alone.
These findings further justify and reinforce NHS England’s decision to provide free CGM for all pregnant women with type 1. Furthermore, these new data may also be useful to future campaigns for more widespread use of CGM.
Why did they do this research?
In 2017 a JDRF funded a clinical trial called ‘CONCEPTT’ which was co-led by Dr Helen Murphy at the University of East Anglia. The trial found that women with type 1 who used CGM along with self-monitoring of blood glucose during pregnancy had lower HbA1c levels and spent an average of 100 minutes per day longer in the target glucose range than women that only self-monitored. They were also more likely to have babies that were born at a healthy weight and who were less likely to be admitted into a neonatal intensive care unit (NICU).
Following this study, NHS England agreed to provide CGM to all pregnant women living in England.
In the current study, also led by Dr Murphy, the researchers wanted to see if the cost of providing CGM to pregnant women with type 1 in England could be offset by a reduction in the costs associated with complications in pregnancy and delivery when using self-monitoring of blood glucose alone.
What did they do?
Using data from the 2014-2016 UK National Pregnancy Diabetes Audit, the group first estimated that there would be on average 1441 women with type 1 per year in England. The group then created a computer model which could estimate the costs to the NHS associated with the use of CGM and self-monitoring of blood glucose by pregnant women with type 1. Using the model, they offset these costs against the costs of complications directly linked to poorer blood glucose management found in those that solely self-monitored.
From 2017’s CONCEPTT trial and other databases, they focussed on complications surrounding pre-eclampsia, NICU admissions and the duration of hospitalisation.
What did they find?
Using the computer model, the group found that if 1441 women with type 1 relied on self-monitoring of blood glucose alone during 28 weeks of pregnancy, this would cost the NHS a total of £28,725,648 in a year. This covered glucose management as well as management of complications surrounding pregnancy and delivery.
When the same number of women added CGM to their blood glucose monitoring, the associated costs dropped to £14,165,187 – even while factoring in cost of the CGMs. This was due to a reduction in the management of complications – for example the number of days spent in a NICU.
Overall, the computer model showed that the NHS would save around £9.5 million when women with type 1 used CGM during pregnancy.
What does this mean for type 1?
Although CGM is now becoming available on the NHS for all pregnant women in England with type 1, this new study shows that its use throughout pregnancy is highly cost-effective as well as beneficial to both the mother and the baby.
These findings not only support and justify widening NHS access to CGM to pregnant women with type 1, but they could also be used in future campaigns for CGM to become available during pregnancy across the rest of the UK. This means that more pregnant women with type 1 may be able to access technology – free of charge – which will be of benefit to themselves and their baby.