Table 1 Scenarios tested in the BIA

1

No hypoglycaemia or DKA with CGM

Newer versions of the CGM sensor device provide alerts of impending hypo- or hyperglycaemia. Therefore, they can potentially prevent all episodes of hypoglycaemia and DKA. In this scenario, all inputs were kept the same as the basecase except CGM patients had no hypoglycaemia or DKA episodes.

2

Higher SMBG testing frequency

This was based on the pivotal trial extension study for CGM in T2DM patients, where the average sensor-scanning frequency was 7.1 times per day (median 5.7) [20].

3

Lower SH Hospital admission rate

Some patients require hospital admission to resolve their hypoglycaemia. In the Spanish BIA, this was set to 15.6% of A&E cases [15].

4

Highest admission cost

According to the National Tariff, the cost of admission with a CC score of 8 + for SH and DKA is £3,901 and £4,138 [29].

5

Lowest admission cost

According to the National Tariff, the cost of admission with a CC score of 0–1 for SH and DKA is £570 and £934 [29].

6

Higher rates for mild hypoglycaemia

The basecase utilised the median rates reported by the UK Hypoglycaemia Study Group [22]. In this scenario, the mean rates for T2DM insulin users < 2 years and > 5 years were used; 4.08 PPPY for basal and premixed and insulin users, 10.2 PPPY for basal-bolus and bolus insulin users [22].

7

More expensive glucagon injection

Here, the cost of the more expensive Ogluo 1 mg/0.2 ml pre-filled pens was used; £73.00 [23, 27], rather than the less expensive Drug Tariff price; £11.52 [23]

8

Lower rate of glucagon use

Glucose oral gel prescribing exceeds mild hypoglycaemias by 19 times. It is reasonable to assume the same applies to glucagon prescribing for SH. In this scenario, usage frequency was reduced by 19 times (from 8.9–0.5%).

9

Most favourable CGM conditions

Combination of inputs from scenarios 1 (No hypoglycaemia or DKA with CGM), 2 (Higher SMBG testing frequency), 4 (Highest admission cost) and 6 (Higher rates for mild hypoglycaemia).