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Abstract Aims In 2022, the Centers for Medicare & Medicaid Services released proposed changes to Medicare's continuous glucose monitoring (CGM) coverage policy, making individuals with a history of problematic hypoglycaemia eligible for CGM coverage, irrespective of insulin use. This study estimated the burden of hypoglycaemia in Medicare Advantage beneficiaries with noninsulin‐treated type 2 diabetes (T2D). Materials and Methods We retrospectively analysed US healthcare claims data using Optum's deidentified Clinformatics® database. Noninsulin‐treated beneficiaries were identified in the 16 years from January 2007 to March 2023. Hypoglycaemia‐related encounters (HREs) were those accompanied by a hypoglycaemia‐specific ICD‐9/10 diagnosis code in any position on the claim or the first or second position. HREs following the first claim related to T2D were reported by setting (ambulatory or inpatient/emergency department ED). Results HREs were identified in 689,853 (21.4%) of 3,229,695 noninsulin‐treated Medicare Advantage beneficiaries, of whom 82.9% ( n = 571,581) had ≥1 HRE in an ambulatory location and 26.8% ( n = 184,833) in an ED/inpatient location. Use of sulfonylurea (odds ratio OR: 4.33 confidence interval CI: 4.27–4.38), evidence of end‐stage kidney disease (OR: 2.87 CI: 2.79–2.94), hypertension (OR: 3.09 CI: 3.04–3.15) and retinopathy (OR: 2.94 CI: 2.82–3.07) were the strongest predictors of an HRE ( p 80% of HREs occur in the ambulatory setting and >70% occur in patients not taking sulfonylureas, primary care providers should be aware of the latest eligibility criteria for Medicare's coverage of CGM and not restrict this technology to their sulfonylurea‐treated patients.
Hannah et al. (Mon,) studied this question.