scholarly journals Accuracy of Flash Glucose Monitoring in Patients with Diabetes Mellitus on Hemodialysis and Its Relationship with Hydration Status

2020 ◽  
pp. 193229682097505
Author(s):  
Idoia Genua ◽  
Joan Sánchez-Hernandez ◽  
Maria José Martínez ◽  
Isabel Pujol ◽  
Jaume Places ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Patient Satisfaction ◽  
Ad Hoc ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Hydration Status ◽  
Flash Glucose Monitoring ◽  
Freestyle Libre ◽  
Interstitial Glucose ◽  
Capillary Glucose

Background: The use of flash-glucose monitoring system FreeStyle Libre (FSL) has demonstrated benefits in metabolic control and quality of life in different populations with diabetes mellitus (DM), being funded in many countries. Due to this, DM subjects on hemodialysis (HD) are using FSL despite the accuracy in this population being unclear. The aims of the present study are to assess the accuracy of FSL in DM subjects on HD, its relationship to hydration status, and patient satisfaction. Material and Methods: A prospective study in 16 patients with DM in a chronic HD program was conducted. Interstitial glucose values from FSL during a 14-day period were compared to capillary glucose measurements obtained at the same time. Hydration status was measured via bioimpedance spectroscopy. Satisfaction with FSL was obtained from an ad hoc satisfaction questionnaire. Results: A total of 766 paired interstitial and capillary glucose levels were analyzed. A correlation coefficient of 0.936 was determined and a mean absolute relative difference (MARD) value of 23%, increasing to 29% during HD. MARD was not related to hydration status. Interstitial glucose values were lower during HD (100.1 ± 17 mg/dL) than within the 12 hours after (125.1 ± 39 mg/dL; P = .012) and the days without HD (134.2 ± 32 mg/dL; P = .001). Subjects showed high satisfaction with FSL. Conclusion: The accuracy of FSL in DM patients on HD is lower than in other populations, especially during HD sessions and is not related with the hydration status. Despite this, the degree of patient satisfaction with FSL is very high.

scholarly journals Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Fenghua Sun ◽  
Waris Wongpipit ◽  
Wendy Y. J. Huang ◽  
Stephen H. S. Wong
Keyword(s):  
Young Adults ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Relative Difference ◽  
Flash Glucose Monitoring ◽  
Grid Analysis ◽  
Crossover Studies ◽  
Freestyle Libre ◽  
Clarke Error Grid ◽  
Error Grid

Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults.Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast.Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland–Altman analysis showed a bias of −1.03 mmol⋅L–1 in SIT, −0.89 mmol⋅L–1 in 20iP + CONT, −0.82 mmol⋅L–1 in iP + CONT, and −1.23 mmol⋅L–1 in 20iP + ACCU. The Clarke error grid analysis showed that 99.6–100% of the values in all trials fell within zones A and B.Conclusion: Although FGM readings underestimated PG, the FGM accuracy was overall clinically acceptable during postprandial rest and walking in overweight/obese young adults.

scholarly journals A Multicenter Evaluation of the Performance and Usability of a Novel Glucose Monitoring System in Chinese Adults With Diabetes

2016 ◽  
Vol 11 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Linong Ji ◽  
Xiaohui Guo ◽  
Lixin Guo ◽  
Qian Ren ◽  
Nan Yu ◽  
...  
Keyword(s):  
Glucose Monitoring ◽  
Relative Difference ◽  
Glucose Sensing ◽  
Chinese Patients ◽  
Chinese Adults ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
Interstitial Glucose ◽  
Error Grid

Objective: Flash glucose monitoring is a new glucose sensing technique that measures interstitial glucose levels for up to 14 days and does not require any calibration. The aim of this study is to evaluate the performance of the new system in Chinese patients with diabetes. Methods: A multicenter, prospective, masked study was performed in a total of 45 subjects with diabetes. Subjects wore 2 sensors at the same time, for up to 14 days. The accuracy was evaluated against capillary blood glucose (BG) and venous Yellow Springs Instrument (YSI; Yellow Springs, OH) measurements. During all 14 days, subjects were asked to perform at least 8 capillary BG tests per day. Each subject attended 3 days of 8-hour clinic sessions to measure YSI and sensor readings every 15 minutes. Results: Forty subjects had evaluable glucose readings, with 6687 of 6696 (99.9%) sensor and capillary BG pairs within consensus error grid zones A and B, including 5824 (87.0%) in zone A. The 6969 sensor and venous YSI pairs resulted in 6965 (99.9%) pairs within zones A and B, including 5755 (82.6%) in zone A. The sensor pairs with BG and YSI result in mean absolute relative difference (MARD) of 10.0% and 10.7%, respectively. Overall between-sensor coefficient of variation (CV) was 8.0%, and the mean lag time was 3.1 (95% confidence interval 2.54 to 4.29) minutes. Conclusions: The system works well for people with diabetes in China, and it is easy to wear and use.

scholarly journals Clinical Approach to Flash Glucose Monitoring: An Expert Recommendation

2019 ◽  
Vol 14 (1) ◽  
pp. 155-164 ◽  
Author(s):  
Ana Chico ◽  
Eva Aguilera ◽  
Francisco Javier Ampudia-Blasco ◽  
Virgina Bellido ◽  
Roque Cardona-Hernández ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Scientific Evidence ◽  
Glucose Monitoring ◽  
Clinical Approach ◽  
Flash Glucose Monitoring ◽  
Maximum Benefit ◽  
Freestyle Libre ◽  
System Use ◽  
Interstitial Glucose

The flash glucose monitoring (FGM) system FreeStyle Libre® is a device that measures interstitial glucose in a very simple way and indicates direction and speed of glucose change. This allows persons with diabetes to prevent hypoglycemic and hyperglycemic events. Scientific evidence indicates that the system can improve glycemic control and quality of life. To obtain the maximum benefit, it is necessary to properly handle glucose values and trends. Due to the generalization of the system use, the purpose of the document is to provide recommendations for the optimal use of the device, not only in the management of glucose values and trends but also in the prevention of hypoglycemia, actuation in exercise, special situations, and retrospective analysis of the glucose data, among others.

How to place a FreeStyle Libre in veterinary patients

2020 ◽  
Vol 11 (6) ◽  
pp. 276-279
Author(s):  
Charlotte Fennell
Keyword(s):  
Diabetes Mellitus ◽  
Monitoring System ◽  
Nursing Care ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Freestyle Libre ◽  
Flash Glucose Monitoring System

This article will discuss the recently developed flash glucose monitoring system (FreeStyle Libre, Abbot) and its current use in diabetic veterinary patients. The placement, monitoring and interpretation of the device is presented. Diabetes mellitus is a common endocrinopathy seen in both first opinion and referral veterinary hospitals and these cases require a large amount of nursing care. Therefore, the registered veterinary nurse should have a good understanding of the disease itself, treatment required and how best to support their clients during this time.

scholarly journals Comparison of Interstitial Fluid Glucose Levels Obtained by Continuous Glucose Monitoring and Flash Glucose Monitoring in Patients With Type 2 Diabetes Mellitus Undergoing Hemodialysis

2019 ◽  
Vol 14 (6) ◽  
pp. 1088-1094 ◽  
Author(s):  
Takahiro Yajima ◽  
Hiroshi Takahashi ◽  
Keigo Yasuda
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Interstitial Fluid ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Flash Glucose Monitoring ◽  
Grid Analysis ◽  
Error Grid

Background: The accuracy of flash glucose monitoring (FGM, FreeStyle Libre Pro [FSL-Pro]) remains unclear in patients with type 2 diabetes mellitus (T2DM) undergoing hemodialysis. Methods: We assessed 13 patients with T2DM undergoing hemodialysis. They simultaneously underwent FGM, continuous glucose monitoring (CGM, iPro2), and self-monitoring blood glucose (SMBG). Results: Parkes error grid analysis against SMBG showed that 49.0% and 51.0% of interstitial fluid glucose (ISFG) levels measured using FGM and 93.3% and 6.7% of those measured using CGM fell into zones A and B, respectively. Mean absolute relative difference (MARD) against SMBG for FGM was significantly higher than that for CGM (19.5% ± 13.2% vs 8.1% ± 7.6%, P < .0001). Parkes error grid analysis of 2496 paired ISFG levels between FGM and CGM showed that 53.6%, 46.2%, and 0.2% of the plots fell into zones A, B, and C, respectively. Mean ISFG levels were lower with FGM than with CGM (143.7 ± 67.2 mg/dL vs 164.6 ± 58.5 mg/dL; P < .0001). Mean absolute relative difference of ISFG levels between FGM and CGM was 19.2% ± 13.8%. Among three groups classified according to CGM ISFG levels (hypoglycemia, <70 mg/dL; euglycemia, 70-180 mg/dL; and hyperglycemia, >180 mg/dL), the MARDs for hypoglycemia (31.9% ± 25.0%) and euglycemia (22.8% ± 14.6%) were significantly higher than MARD for hyperglycemia (13.0% ± 8.5%) ( P < .0001 in both). Conclusions: Flash glucose monitoring may be clinically acceptable. Average ISFG levels were lower with FGM than with CGM, and MARDs were higher for hypoglycemia and euglycemia in patients with T2DM undergoing hemodialysis.

scholarly journals Flash Glucose Monitoring: Differences Between Intermittently Scanned and Continuously Stored Data

2017 ◽  
Vol 12 (2) ◽  
pp. 397-400 ◽  
Author(s):  
Stefan Pleus ◽  
Ulrike Kamecke ◽  
Manuela Link ◽  
Cornelia Haug ◽  
Guido Freckmann
Keyword(s):  
Health Care Professionals ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Additional Information ◽  
Therapeutic Decisions ◽  
Freestyle Libre ◽  
Interstitial Glucose ◽  
Data Points ◽  
Flash Glucose Monitoring System ◽  
Relative Differences

The flash glucose monitoring system FreeStyle Libre (Abbott Diabetes Care Ltd., Witney, UK) measures interstitial glucose concentrations and continuously stores measurement values every 15 minutes. To obtain a current glucose reading, users have to scan the sensor with the reader. In a clinical trial, 5% of the scanned data showed relative differences of more than ±10% compared with continuously stored data points (median −0.5%). Such differences might impact results of studies using this system. It should be indicated whether scanned or continuously stored data were used for analyses. Health care professionals might have to differentiate between data reports from clinical software and the scanned data their patients are provided with. Additional information on these differences and their potential impact on therapeutic decisions would be helpful.

scholarly journals Differences of FreeStyle Libre Flash Glucose Monitoring System and Finger Pricks on Clinical Characteristics and Glucose Monitoring Satisfactions in Type 1 Diabetes Using Insulin Pump

2019 ◽  
Vol 12 ◽  
pp. 117955141986110 ◽  
Author(s):  
Ayman A Al Hayek ◽  
Asirvatham A Robert ◽  
Mohamed A Al Dawish
Keyword(s):  
Insulin Pump ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Daily Insulin Dose ◽  
Freestyle Libre ◽  
Capillary Glucose ◽  
The Mean ◽  
Bolus Insulin

Background: To evaluate the different experience of freestyle libre and finger pricks on clinical characteristics and glucose monitoring satisfaction (GMS) in patients with type 1 diabetes (T1D) using insulin pump (IP). Methods: A prospective study was carried out on 47 (aged 17-21 years) T1D, who used conventional finger-pricking method for self-testing the glucose. The experiments were conducted between March 2018 and September 2018. For carrying out the study, the flash glucose monitoring (FGM) sensors were placed on each participant, at the baseline visit, by a trained diabetes educator. Furthermore, to determine the total number of scans conducted during the study period, the respective ambulatory glucose profiles were generated by computing the data collected from the sensors. In addition, a trained interviewer handed over the GMS questionnaire to each patient, at the baseline and at 12 weeks of the study. Results: In comparison to the baseline (finger pricks), various parameters such as: HbA1c ( P = .042), hypoglycemia ( P = .001), mean capillary glucose ( P = .004), total daily insulin dose ( P = .0001), percentage of bolus insulin ( P = .0001), daily bolus frequency ( P = .0001), and daily carbohydrates intake ( P = .0001) showed a significant improvement at 12 weeks. Similarly, substantial augmentation was noticed, in the sub domains of GMS, that is, openness ( P = .0001), emotional burden ( P = .0001), behavioral burden ( P = .0001), and trust ( P = .0001) at 12 weeks as compared to baseline. Overall, total GMS score at baseline was 1.72 ± 0.37, which increased up to 3.41 ± 0.49 ( P = .0001) in the time period of 12 weeks. The HbA1c (r2 = 0.45), hypoglycemia (r2 = 0.58), and the mean number of FGM scans, exhibited a negative correlation, while GMS (r2 = 0.52) and the mean number of FGM scans, exhibited a positive correlation. Conclusion: The frequency of hypoglycemia, HbA1c level, capillary glucose, daily carbohydrates intake decreased, while the total daily insulin dose, daily bolus insulin and total GMS score increased with the use of FGM scanning for 12 weeks.

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