Effectiveness of the Freestyle Libre Flash Glucose Monitoring System on Diabetes Distress Among Individuals with Type 1 Diabetes: A Prospective Study

Abstract

Aim: To study and explore the intervention of the flash glucose monitoring system (FGMS) on diabetes-related distress (DRD) in children and adolescents with type 1 diabetes (T1D). Methods: A 12-week prospective study was performed from March 2019 to July 2019 involving 187 children and adolescents (age range 13-19 years; 56.7% female) with T1D who were self-testing their glucose levels using the conventional fingerprick method. At the time of the baseline visit, FGMS sensors were fixed by a trained diabetes educator onto each patient in the study population. A trained interviewer also administered the 28-item T1-Diabetes Distress Scale (T1-DDS) questionnaire to each participant at the baseline visit and again after 12 weeks to determine the T1-DDS score. Results: Comparison of the baseline (fingerprick) data with data collected at 12 weeks after the patients had switched to the FGMS revealed a significant decrease in the subdomains of the T1-DDS as follows: powerlessness (p = 0.0001); management distress (p = 0.0001); hypoglycemia distress (p = 0.0001); negative social perceptions (p = 0.0001); eating (p = 0.0001); physician distress (p = 0.0001); friend/family distress (p = 0.0001); and total T1-DDS score (p = 0.0001). Similarly, analysis of the data revealed that there was also a substantial drop from baseline to 12 weeks after initiation of the intervention in the clinical variables assessed, such as glycosylated hemoglobin; specifically, there was a considerable decrease after 12 weeks in the frequency of hypoglycemia. Interestingly, the frequency of glucose monitoring also showed an upswing among users of the FGMS. Conclusion: The outcomes of this study clearly demonstrate that once the patients had been switched from the fingerprick method to FGMS, the DRD and related clinical parameters showed remarkable improvement. However, further studies are necessary to determine whether the continued and consistent use of the FGMS will achieve better results.

Assessing Diabetes Distress and Sleep Quality in Young Adults with Type 1 Diabetes Using FreeStyle Libre: A Prospective Cohort Study

“…Such studies have focused on adult T1DM patients and European populations. A prospective study in Saudi Arabia demonstrated ; p = 0.001) [32]. A recent study reported that continuous glucose monitoring in adolescents with T1DM is associated with lower diabetes-related distress [33].…”

Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy

“…Therefore, that these patients maintained good glycaemic control is reassuring in terms of their effective self-management of diabetes. We speculate that the use of FGM combined with insulin pump therapy contributed to this effect [30]; for example by limiting diabetes-related distress [31].…”

Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well‐controlled youth with type 1 diabetes

“…44 Differences between capillary glucose values and sensor readings should be explained to school personnel to avoid wrong treatment decisions due to poor knowledge of the device, complemented with frequent updates when new information is available. 45 This single-center unselected pediatric population was wellcontrolled at baseline with mean HbA1c of 7.2% (55 mmol/mol), which is better than what has been reported for other studies assessing the impact of isCGM, [14][15][16]28,46,47 for general populations followed through diabetes registries, [48][49][50][51] and even for the whole Belgian pediatric population. 52 We are the first to follow a population up to 24 months after isCGM initiation.…”

“…Studies with poorly controlled subjects observed a modest decrease in HbA1c after 2 to 3 months. 14,28,46,47 Only one of these studies followed the study population for a longer period of time, here HbA1c was not different after 12 months of isCGM use than at baseline. 14 31,32,54 In addition, it has been reported that pressureinduced sensor attenuation can cause false low measurements, 55 especially seen at night, and thus hyperglycemia due to unnecessary carbohydrate intake.…”