Flash Glucose Monitoring Systems in Pediatric Populations With Diabetes

Abstract


 Flash glucose monitoring (FGM) is a method of glucose testing where a sensor inserted into the skin continuously measures interstitial glucose levels. It can be used by people with diabetes to inform treatment decisions, such as insulin dosing, as an alternative or complement to blood glucose testing.
 Evidence of variable quality from 2 randomized controlled trials and 8 non-randomized studies, including those summarized within systematic reviews, suggests that FGM may improve quality of life, patient satisfaction, diabetes distress, self-efficacy, and frequency of glucose monitoring compared to self-monitoring blood glucose techniques in pediatric populations with type 1 diabetes. Findings related to other outcomes, such as hemoglobin A1C, glucose time in range metrics, and adverse events were mixed or inconclusive (i.e., in some studies the use of FGM was associated with improved outcomes, while in other studies it was not).
 While the results summarized in this report generally suggest that the use of FGM is associated with improved clinical outcomes in pediatric populations with type 1 diabetes, the limitations of the included literature should be considered when interpreting these findings.
 No studies were identified that compared the clinical effectiveness of FGM systems with hypoglycemic, hyperglycemia, or signal loss alarms (e.g., FreeStyle Libre 2) to FGM systems without these features (e.g., FreeStyle Libre) in people of any age with diabetes requiring insulin therapy.

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“…More recently, CADTH completed a review of the FreeStyle Libre systems in the pediatric T1DM population, 36 concluding that the evidence indicates that the systems may improve QOL, patient satisfaction, diabetes distress, self-efficacy, and frequency of glucose monitoring compared to SMBG. The report noted that findings related to HbA1c, glucose TIR metrics, and adverse events were mixed; but ultimately concluded that the use of either of the FreeStyle Libre systems is associated with improved clinical outcomes in pediatric populations with T1DM.…”