No abstract

IntroductionThe FreeStyle Libre is a flash glucose monitoring (FSL-FGM) system. Compared with finger-prick based self-monitoring of blood glucose, FSL-FGM may provide benefits in terms of improved glycemic control and decreased disease burden.MethodsProspective nationwide registry. Participants with diabetes mellitus (DM) used the FSL-FGM system for a period of 12 months. End points included changes in HbA1c, hypoglycemia, health-related quality of life (12-Item Short Form Health Surveyv2 (SF-12v2) and 3-level version of EuroQol 5D (EQ-5D-3L)), a specifically developed patient-reported outcome measures (PROMs) questionnaire, diabetes-related hospital admission rate and work absenteeism. Measurements were performed at baseline, and after 6 months and 12 months.Results1365 persons (55% male) were included. Mean age was 46 (16) years, 77% of participants had type 1 DM, 16% type 2 DM and 7% other forms. HbA1c decreased from 64 (95%CI 63 to 65) mmol/mol to 60 (95%CI 60 to 61) mmol/mol with a difference of −4 (95% CI −6 to 3) mmol/mol. Persons with a baseline HbA1c >70 mmol/mol had the most profound HbA1c decrease: −9 (95% CI −12 to to 5) mmol/mol. EQ-5D tariff (0.03 (95%CI 0.01 to 0.05)), EQ-VAS (4.4 (95%CI 2.1 to 6.7)) and SF-12v2 mental component score (3.3 (95%CI 2.1 to 4.4)) improved. For most, PROMs improved. Work absenteeism rate (/6 months) and diabetes-related hospital admission rate (/year) decreased significantly, from 18.5% to 7.7% and 13.7% to 2.3%, respectively.ConclusionsReal world data demonstrate that use of FSL-FGM results in improved well-being and decreased disease burden, as well as improvement of glycemic control.

The evolution of reproductive isolation by flowering time displacement between two cytotypes that produce inviable hybrids was studied by computer simulations in an isolation-by-distance model. Flowering time distribution was stabilized by mass-action, both by the mating procedure and by pollen-limited seed-production in early or late flowering plants. Coexistence had to last long enough for flowering time divergence to evolve. This could only be achieved in a mosaic of local patches or parapatry. The model showed that flowering time displacement occurred despite the stabilizing effect of mass-action and the restricted width of the interaction zone. Initially an inverse dine for flowering time was formed but after 200 generations this dine had become monotonic. In contrast to the possible swamping effect by gene flow from outside the zone, there was a spread of genes into the allopatric ranges.

The hypothesis of autotetraploidy in Plantago media (2n =12 and 2n = 24) was tested. The two cytotypes are morphologically very similar. Rare 4X and 3X hybrids were obtained in inter-ploidy crosses. The reproductive isolation between 2X and 4X is post-zygotic and can be broken down and introduced by colchicine treatment. The studied diploid and tetraploid populations shared the same alleles for nine allozyme loci. Together this provides strong evidence for autotetraploid origin of tetraploid P. media. Fertility of colchicine tetraploids was comparable to natural tetraploids and slightly lower than natural diploids. In contrast to colchicine tetraploids, natural tetraploids did not show gigascharacteristics. Tetraploid hybrids between diploids and natural tetraploids showed partial gigas-characteristics. The possible reasons for the differences in cell size between cytotypes are discussed. Differentiating characters between the natural cytotypes were not affected by colchicine treatment and are therefore not a direct consequence of polyploidization.