scholarly journals Flash Glucose Monitoring: A Review of the Literature with a Special Focus on Type 1 Diabetes

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 992 ◽  
Author(s):  
Giulia Mancini ◽  
Maria Berioli ◽  
Elisa Santi ◽  
Francesco Rogari ◽  
Giada Toni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Care ◽  
Glycemic Control ◽  
Health Care Professionals ◽  
Glucose Monitoring ◽  
Special Focus ◽  
Flash Glucose Monitoring

In people with type 1 diabetes mellitus (T1DM), obtaining good glycemic control is essential to reduce the risk of acute and chronic complications. Frequent glucose monitoring allows the adjustment of insulin therapy to improve metabolic control with near-normal blood glucose concentrations. The recent development of innovative technological devices for the management of T1DM provides new opportunities for patients and health care professionals to improve glycemic control and quality of life. Currently, in addition to traditional self-monitoring of blood glucose (SMBG) through a glucometer, there are new strategies to measure glucose levels, including the detection of interstitial glucose through Continuous Glucose Monitoring (iCGM) or Flash Glucose Monitoring (FGM). In this review, we analyze current evidence on the efficacy and safety of FGM, with a special focus on T1DM. FGM is an effective tool with great potential for the management of T1DM both in the pediatric and adult population that can help patients to improve metabolic control and quality of life. Although FGM might not be included in the development of an artificial pancreas and some models of iCGM are more accurate than FGM and preferable in some specific situations, FGM represents a cheaper and valid alternative for selected patients. In fact, FGM provides significantly more data than the intermittent results obtained by SMBG, which may not capture intervals of extreme variability or nocturnal events. With the help of a log related to insulin doses, meal intake, physical activity and stress factors, people can achieve the full benefits of FGM and work together with health care professionals to act upon the information provided by the sensor. The graphs and trends available with FGM better allow an understanding of how different factors (e.g., physical activity, diet) impact glycemic control, consequently motivating patients to take charge of their health.

scholarly journals Two-year use of flash glucose monitoring is associated with sustained improvement of glycemic control and quality of life (FLARE-NL-6)

2021 ◽  
Vol 9 (1) ◽  
pp. e002124
Author(s):  
Annel Lameijer ◽  
Marion J Fokkert ◽  
Mireille A Edens ◽  
Reinold O B Gans ◽  
Henk J G Bilo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Sustained Improvement ◽  
Positive Effects ◽  
Freestyle Libre ◽  
Continued Use

IntroductionThe FreeStyle Libre (FSL) is a flash glucose monitoring (FGM) system. The Flash Monitor Register in the Netherlands (FLARE-NL-4) study previously demonstrated the positive effects of FSL-FGM use during 1 year on glycemic control, quality of life and disease burden among persons with diabetes mellitus (DM). The present follow-up study assesses the effects of FSL-FGM after 2 years.Research design and methodsPatients included in the FLARE-NL-4 study who continued FSL-FGM during the 1-year study period were invited to participate (n=687). Data were collected using questionnaires (the 12-Item Short Form Health Survey version 2 (SF-12v2) and the EuroQol 5-Dimension 3-Level (EQ-5D-3L) for quality of life), including self-reported hemoglobin A1c (HbA1c).ResultsA total of 342 patients agreed to participate: mean age 48.0 (±15.6) years, 52% men and 79.5% with type 1 DM. HbA1c decreased from 60.7 (95% CI 59.1 to 62.3) mmol/mol before use of FSL-FGM to 57.3 (95% CI 55.8 to 58.8) mmol/mol after 1 year and 57.8 (95% CI 56.0 to 59.5) mmol/mol after 2 years. At the end of the 2-year follow-up period, 260 (76%) persons were still using the FSL-FGM and 82 (24%) had stopped. The main reason for stopping FSL-FGM was financial constraints (55%). Concerning the whole 2-year period, there was a significant decrease in HbA1c among persons who continued use of FSL-FGM (−3.5 mmol/mol, 95% CI −6.4 to –0.7), while HbA1c was unaltered compared with baseline among persons who stopped FSL-FGM (−2.4 mmol/mol, 95% CI −7.5 to 2.7): difference between groups 2.2 (95% CI −1.3 to 5.8) mmol/mol. After 2 years, persons who continued use of FSL-FGM had higher SF-12 mental component score and higher EQ-5D Dutch tariff score and felt less often anxious or depressed compared with persons who discontinued FSL-FGM.ConclusionsAlthough the considerable number of non-responders limits generalizability, this study suggests that persons who continue to use FSL-FGM for 2 years may experience sustained improvement in glycemic control and quality of life.

scholarly journals Diabetes Telehealth Solutions: Improving Self-Management Through Remote Initiation of Continuous Glucose Monitoring

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Robin L Gal ◽  
Nathan J Cohen ◽  
Davida Kruger ◽  
Roy W Beck ◽  
Richard M Bergenstal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Diabetes Distress ◽  
Quality Of Life Indicators ◽  
Freestyle Libre ◽  
Time In Range

Abstract The purpose of this study was to evaluate feasibility of initiating continuous glucose monitoring (CGM) through telehealth as a means of expanding access. Adults with type 1 diabetes (N = 27) or type 2 diabetes using insulin (N = 7) and interest in starting CGM selected a CGM system (Dexcom G6 or Abbott FreeStyle Libre), which they received by mail. CGM was initiated with a certified diabetes care and education specialist providing instruction via videoconference or phone. The primary outcome was days per week of CGM use during the last 4 weeks. Hemoglobin A1c (HbA1c) was measured at baseline and 12 weeks. Participant self-reported outcome measures were also evaluated. All 34 participants (mean age, 46 ± 18 years; 53% female, 85% white) were using CGM at 12 weeks, with 94% using CGM at least 6 days per week during weeks 9 to 12. Mean HbA1c decreased from 8.3 ± 1.6 at baseline to 7.2 ± 1.3 at 12 weeks (P < .001) and mean time in range (70-180 mg/dL, 3.9-10.0 mmol/L) increased from an estimated 48% ± 18% to 59% ± 20% (P < .001), an increase of approximately 2.7 hours/day. Substantial benefits of CGM to quality of life were observed, with reduced diabetes distress, increased satisfaction with glucose monitoring, and fewer perceived technology barriers to management. Remote CGM initiation was successful in achieving sustained use and improving glycemic control after 12 weeks as well as improving quality-of-life indicators. If widely implemented, this telehealth approach could substantially increase the adoption of CGM and potentially improve glycemic control for people with diabetes using insulin.

scholarly journals Relationship Among Health-Related Quality of Life and Autosomal Ancestry, Clinical and Socioeconomic Factors In Type 1 Diabetes in an Admixed Brazilian Population.

2021 ◽  
Author(s):  
Rossana Sousa Azulay ◽  
Débora Lago ◽  
Glaucia Abreu Silva Santos ◽  
Maria da Gloria Tavares ◽  
Vandilson Rodrigues ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Health Related Quality ◽  
Chronic Complications ◽  
Related Quality ◽  
Health Related

Abstract BACKGROUND: Type 1 diabetes is a chronic disease of an autoimmune character that affects the quality of life of patients in different degrees. Race and socioeconomic differences directly affect glycemic control. This study aimed to evaluate the Health-related quality of life (HRQoL) of Type 1 diabetes mellitus (T1D) patients an admixed Brazilian population, and to identify the variables influencing this condition.METHODS: This research is a cross-sectional study conducted at the University Hospital-Federal University of Maranhão Endocrinology Service with 152 T1D patients between 2017 and 2018. HRQoL information was obtained from two self-completed questionnaires: Short Form-6 dimensions and EuroQol-5 dimensions with visual analog scale. For inference of autosomal ancestry, a panel of 46 autosomal informational insertion/deletion ancestry markers (AIM–Indels) was used. Demographic information, socioeconomic data, presence of chronic complications, glycemic control level, and type of treatment were collected.RESULTS: In the study, the patients who had good HRQoL were characterized as follows: male, under 18 years old, single, with average of 11 years of schooling, had health insurance, with less than 5 years of diagnosis, practiced physical activity, experienced no hypoglycemia in the last 30 days, reported no chronic complications (retinopathy and nephropathy), participant in several group educational activities, used analogous insulin, monitored blood glucose, showed maximum treatment adherence, and came from the secondary service. Autosomal ancestry and self-reported color/race did not show influence on HRQoL indexes.CONCLUSION: Our study is the first to measure the HRQoL, autosomal ancestry and recognize the impact of T1D on patients' lives in the State of Maranhão, Northeast of Brazil. The results validate the need to provide T1D patients with continuous training on self-management and self-monitoring, seeking better results in metabolic control and consequently, in the prevention of acute and chronic complications to generate positive impacts on the quality of life of this population. In addition, reinforcing physical activity at each appointment should be part of the health team’s routine. We understand that ethnicity in a highly mixed population like ours did not influence the quality of life of these patients.

Insulin Management for Type 1 Diabetic Patients During Social Alcohol Consumption: The SPRITZ Study

2020 ◽  
Vol 16 (6) ◽  
pp. 619-627
Author(s):  
Elisa Cipponeri ◽  
Cesare Blini ◽  
Christian Lamera ◽  
Valentina De Mori ◽  
Giovanni Veronesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Glycemic Control ◽  
Educational Program ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Adult Type ◽  
Time To Peak

Background : There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or “happy hours”. Introduction: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Introduction : This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Methods: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. Results : After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. Conclusion: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.

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