Background: In Sweden, FreeStyle Libre a flash glucose monitoring system came onto the market in 2014 as a complement to self-monitoring of blood glucose. The aim of this study was to evaluate the accuracy and treatment experience of the FreeStyle Libre system.Methods: Fifty-eight adults with type 1 diabetes used FreeStyle Libre for 10–14 days and measured capillary blood glucose levels with the HemoCue blood glucose measurement system at least six times a day simultaneously.Results: For the entire study period, the mean absolute relative difference (MARD) was 13.2% (95% confidence interval [CI] 12.0%–14.4%). MARD was 13.6% (95% CI 12.1%–15.4%) during week 1 and 12.7% (95% CI 11.5%–13.9%) during week 2. The mean absolute difference (MAD) for the whole study period was 19.8 mg/dL (1.1 mmol/L) (95% CI 17.8–21.8 mg/dL), including 20.5 mg/dL (1.14 mmol/L) during week 1 and 19.0 mg/dL (1.05 mmol/L) during week 2. The overall correlation coefficient was 0.96. For glucose values <72, 72–180, and >180 mg/dL (<4, 4–10, and >10 mmol/L), the MARD was 20.3% (95% CI 17.7%–23.1%), 14.7% (95% CI 13.4%–16%), and 9.6% (95% CI 8.5%–10.8%), respectively, and respective MAD values were 12.3, 17.8, and 23.6 mg/dL (0.69, 0.99, and 1.31 mmol/L). Using the 10-item visual analog scale, patients rated their experience with FreeStyle Libre as generally positive, with mean values ranging from 8.22 to 9.8.Conclusions: FreeStyle Libre had a similar overall MARD as continuous blood glucose monitoring systems in earlier studies when studied in similar at-home conditions. The overall patient satisfaction was high.

Introduction Continuous glucose monitoring (CGM) provides detailed information about glucose level fluctuations over time. The method is increasingly being used in pregnant women with type 1 diabetes. However, only one previous study compared CGM results related to pregnancy outcomes in women using insulin pumps with those administering multiple daily injections (MDI). We performed a secondary analysis of CGM metrics from an observational cohort of pregnant women with type 1 diabetes and compared insulin pump and MDI therapies in relation to maternal and neonatal outcomes. Material and methods The study included 185 pregnant Swedish women with type 1 diabetes undergoing CGM throughout pregnancy. Women were divided according to insulin administration mode, ie MDI (n = 131) or pump (n = 54). A total of 91 women used real‐time CGM and 94 women used intermittently viewed CGM. Maternal demographics and maternal and neonatal outcome data were collected from medical records. CGM data were analyzed according to predefined glycemic indices: mean glucose; standard deviation; percentage of time within, below and above glucose target range; mean amplitude of glycemic excursion; high and low glucose indices; and coefficient variation in percent. Associations between insulin administration mode and CGM data, on the one hand, and maternal and neonatal outcomes, on the other, were analyzed with analysis of covariance and logistic regression, respectively, adjusted for confounders. Results There were no differences in maternal characteristics or glycemic indices between the MDI and pump groups, except for a longer duration of type 1 diabetes and higher frequencies of microangiopathy and real‐time CGM among pump users. Despite improvement with each trimester, glucose levels remained suboptimal throughout pregnancy in both groups. There were no differences between the MDI and pump groups concerning the respective associations with any of the outcomes. The frequency of large for gestational age was high in both groups (MDI 49% vs pump 63%) and did not differ significantly. Conclusions Pregnant women with type 1 diabetes did not differ in glycemic control or pregnancy outcome, related to MDI or pump administration of insulin. Glycemic control remained suboptimal throughout pregnancy, regardless of insulin administration mode.

Introduction: Women with type 1 diabetes type have increased risk of preeclampsia but it is not fully understood if degree of glycemic control is associated with this risk. Aims of this study was to assess associations between glycemic control using CGM (continuous glucose monitoring) and risk of preeclampsia and gestational hypertension. Material and methods: 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet based Diasend. Mean glucose, standard deviation (SD), percentage of time within (TIT), below (TBT), and above (TAT) target was presented in each trimester in women with and without preeclampsia. Associations between CGM and preeclampsia and gestational hypertension were analyzed with logistic regression and adjusted for confounders. Results: 20 women (16.6%) developed preeclampsia. There were no significant differences in maternal characteristics between women with or without preeclampsia except for smoking. Glycemic control improved with each trimester but was not optimal in either group. When analyzing associations between glucose variables and preeclampsia, no significant associations were found after adjustment for confounders. In nulliparous women there was a trend, however not significant, of higher mean glucose, higher SD, less TIT, more TAT and less TBT, in those who developed preeclampsia. We found no significant associations between glycemic control and development of gestational hypertension. Conclusions: Degree of glycemic control assessed by CGM was not associated with development of preeclampsia or gestational hypertension in women with type 1 diabetes in this study.