Frequency of Flash Glucose Monitoring Scans and Hemoglobin A1c in Real Life

ObjectiveTo assess the role of flash glucose monitoring in early and late changes in glycemic markers under real-life conditions.Research design and methodsDeidentified glucose results from 6802 flash glucose monitors were analyzed after dividing into high, medium and low-risk groups based on tertiles of time spent in hypoglycemia (min/day <70 mg/dL) or hyperglycemia (hours/day >240 mg/dL). Groups were further subdivided into tertiles of glucose scanning frequency and glycemic measures analyzed in the first 14 days and over 6 months.ResultsImprovement in dysglycemia mainly occurred in the first month of device use. Comparing first and last 14 study days, high-hyperglycemic-risk individuals showed reduced time >240 mg/dL (mean±SEM) from 6.07±0.06 to 5.73±0.09 hours/day (p<0.0001). High-frequency scanners showed 0.82 hours/day reduction in hyperglycemia (p<0.0001) whereas low-frequency scanners failed to demonstrate a benefit. High-hypoglycemic-risk individuals showed reduction in time ≤54 mg/dL from 90±1 to 69±2 min/day (p<0.0001) comparing first and last 14 study days. This reduction was evident in both low and high-frequency scanners but with reduced hyperglycemic exposure in the latter group.ConclusionsUnder real-world conditions, flash monitoring is associated with rapid and sustained reduction in dysglycemia with high-frequency scanners demonstrating more significant reduction in hyperglycemia.

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Assessment of FreeStyle Libre Flash Glucose Monitoring System Implementation in Real Life Clinical Setting: A Prospective Observational Study

Diagnostics ◽

10.3390/diagnostics11020305 ◽

2021 ◽

Vol 11 (2) ◽

pp. 305

Author(s):

Silvija Canecki Varzic ◽

Kristina Steiner ◽

Maja Gradinjan Centner ◽

Mladen Grgurevic ◽

Maja Cigrovski Berkovic ◽

...

Keyword(s):

Observational Study ◽

Clinical Setting ◽

Prospective Observational Study ◽

Real Life ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

Entire Cohort ◽

Freestyle Libre ◽

One Year ◽

Flash Glucose Monitoring System

Background: In this study, we investigated the effectiveness of FreeStyle Libre Flash Glucose Monitoring (FGM) implementation in a real life clinical setting with the emphasis on the effect of initial education on the use of the FGM system. Methods: This prospective observational study included 425 diabetes type 1 subjects followed up for 3 to 12 months (320 were followed up to 3 months, 267 up to 6 months and 147 up to period of one year). An FGM sensor was placed at study entry and all participants were educated through a period of 5 days on sensor usage and self-management of glycemia with follow up visits every 3 months. Results: HbA1c values significantly decreased from baseline (T0) to 3 months (T3) (p < 0.001), with a drop from 7.48% ± 0.1% to 7.30 ± 0.1%. There was no change in time spent in hypoglycemia from T3 to T12, although there was a decreasing trend present. The change in HbA1c values in the entire cohort was driven by change in the subgroup of patients with HbA1c ≥7% with a drop from 8.22% ± 1.14% to 7.68% ± 1.26% (p < 0.0001) in the first 3 months. Also, in individuals performing SMBG less than 5 times per day, there was a steady decrease in HbA1c levels up to 6 months (p < 0.05 and p < 0.001, respectively) as opposed to those who performed SMBG ≥5 times per day. Conclusions: The improvement in HbA1c was mainly driven by the increase in the number of scans per day. The subjects with poorer glycemic control and those who seldom performed SMBG benefited the most.

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