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

Abstract

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.

The Association of Personality Traits and Parameters of Glycemic Regulation in Type 1 Diabetes Mellitus Patients Using isCGM

“…Results of this study demonstrated significant improvement in glycemic management three months from isCGM initiation, which is consistent with clinical experience to date [ 25 , 26 , 27 , 28 ]. Significantly higher HbA1c measurements at baseline were seen in subjects with lower socioeconomic status; these results have also previously been seen in adults and children with T1DM [ 29 , 30 ].…”

An educational programme and patient‐reported outcomes using flash glucose monitoring and automated bolus calculation in type 1 diabetes

“…Our concept, however, is not labour intensive nor resource‐ consuming for a clinic, and it is probably possible to replace some of the follow‐up visits with telephone consultations. Most other education concepts are more time‐consuming 18–20 …”

Flash Glucose Monitoring in Croatia: The Optimal Number of Scans per Day to Achieve Good Glycemic Control in Type 1 Diabetes

“…isCGM FSL appeared on the EU market in 2014 and is available in Croatia since September 2018. In a previous study, we showed in T1DM patients how 3 months of FSL use led to a significant drop in A1C mainly driven by those patients whose A1C was >7% (53 mmol/mol), and the improvement in A1C was mainly correlated to the increase in the number of scans per day [12].…”