A Multicenter Real-Life Study on the Effect of Flash Glucose Monitoring on Glycemic Control in Patients with Type 1 and Type 2 Diabetes

Anjana, Ranjit Mohan; Kesavadev, Jothydev; Deshpande, Neeta; Tiwaskar, Mangesh; Pradeepa, Rajendra; Jebarani, Saravanan; Suresh, T. M.; Sastry, Nadiminty Ganapathi; Kumar, Srivastava Brijendra; Ramu, M; Gupta, Pokal Prasanna Kumar; Vignesh, J P; Chandru, Sundramoorthy; Kayalvizhi, Sengottuvel; Jagdish, Padoor Sethuraman; Uthra, Subash Chandra Bose; Lovelena, Munawar; Jyoti, Sah; Priya, Sengodan Suguna; Kannan, A.; Mohan, Viswanathan; Unnikrishnan, Ranjit

doi:10.1089/dia.2017.0063

Cited by 34 publications

(35 citation statements)

References 14 publications

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“…Two studies compared retrospective CGM using flash CGM with visual charts and counseling to SMBGL. Greater HbA1c reductions were observed following CGM after 12 weeks (−0.9 vs −0.7%, P < 0.001) in 4,678 individuals, but not after 24 weeks (−0.28 vs −0.21%, P = 0.822) of 224 individuals taking multiple daily insulin injections. After 12 weeks, HbA1c reduction with retrospective CGM was similar when combined with either problem‐solving counseling or standard diabetes education (no counseling; −0.7 vs −0.5; P = 0.69).…”

Section: Resultsmentioning

confidence: 99%

“…After removal of duplications, and excluding articles based on title and abstracts, 12 articles, reporting 11 separate studies (one article reporting long-term follow up 24 of a previously reported short-term intervention 25 ) met the inclusion criteria. Nine articles (eight studies) were RCTs [24][25][26][27][28][29][30][31][32] , and three were observational trials [33][34][35] . Included studies were rated as being of acceptable quality 19 .…”

Section: Search Outcomesmentioning

confidence: 99%

“…A total of 5,542 participants were recruited into eight RCTs (n = 5,342) and three observational trials (n = 196), with 60% men 26,34 , and~9% (n = 487) receiving multiple daily insulin injections 30,32 . Nine studies assessed baseline body mass index (BMI) [24][25][26][27][28][30][31][32][33]35 , with the majority of participants classified as overweight or obese (BMI >25 kg/m 2 ; n = 5,432). The RCT sample size ranged between 29 and 4,678 participants, with a mean age range of 52-60 years and diabetes duration of 6.2-19.2 years [24][25][26][27][28][29][30][31][32]35 ; one RCT (n = 40) did not report diabetes duration 29 .…”

Section: Participantsmentioning

confidence: 99%

“…Nine studies assessed baseline body mass index (BMI) [24][25][26][27][28][30][31][32][33]35 , with the majority of participants classified as overweight or obese (BMI >25 kg/m 2 ; n = 5,432). The RCT sample size ranged between 29 and 4,678 participants, with a mean age range of 52-60 years and diabetes duration of 6.2-19.2 years [24][25][26][27][28][29][30][31][32]35 ; one RCT (n = 40) did not report diabetes duration 29 . The observational trials examined 6 to 181 participants with a mean age range of 54-57 years and diabetes duration of 2.1-14.6 years [33][34][35] .…”

Section: Participantsmentioning

confidence: 99%

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Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Taylor

Thompson

Brinkworth

2018

J of Diabetes Invest

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The present narrative review discusses the role of continuous glucose monitoring (CGM) in glycemic and weight control, and lifestyle behavior adherence in adults with type 2 diabetes. A literature search from January 2001 to November 2017 was carried out (MEDLINE, CINAHL, Web of Science and Scopus). Eligible studies were trials evaluating the use of CGM with the aim of achieving glucose control or lifestyle‐related treatment adherence over a period of ≥8 weeks in adults with type 2 diabetes compared with usual care or another comparison intervention, or observational trials reporting CGM user experience. A total of 5,542 participants were recruited into 11 studies (eight randomized controlled trials [n = 5,346] and three observational studies [n = 196]). The sample size ranged 6–4,678 participants, the mean age was 51.7–60.0 years and diabetes duration was 2.1–19.2 years, with high heterogeneity between studies. Overall, the available evidence showed, compared with traditional self‐monitoring of blood glucose levels, CGM promoted greater reductions in glycated hemoglobin, bodyweight and caloric intake; higher adherence rating to a personal eating plan; and increases in physical activity. High compliance to CGM wear‐time and device calibration was reported (>90%). The addition of lifestyle and/or behavioral counseling to CGM appeared to further potentiate these improvements. Preliminary evidence suggests that CGM use promotes glycemic and weight control, and lifestyle behavior adherence in adults with type 2 diabetes. These benefits might be further enhanced with integration of diet, exercise, and glucose excursion education and counseling. However, specific attributes of effective interventions and the application of CGM information for promoting improved outcomes and healthier choices remain unclear.

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Section: Resultsmentioning

confidence: 99%

Section: Search Outcomesmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Taylor

Thompson

Brinkworth

2018

J of Diabetes Invest

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“…Several studies have shown the accuracy of interstitial glucose measurements, and the usefulness and safety of FGM [5][6][7][8][9][10][11] . Furthermore, it has been shown that the use of FGM reduced hypoglycemia in patients with type 1 and type 2 diabetes mellitus, although the effects of FGM on glycemic control are controversial 7,8,[12][13][14][15] . However, in most of the earlier studies, capillary blood glucose, not venous blood glucose, was used as a reference, and the accuracy of glucose measurements by FGM has not been fully determined 5,6,9,10,16 .…”

Section: Introductionmentioning

confidence: 99%

Accuracy of flash glucose monitoring in insulin‐treated patients with type 2 diabetes

Sato

Oshima

Nakata

et al. 2018

J of Diabetes Invest

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The present study evaluated the accuracy of interstitial glucose measurements by flash glucose monitoring ( FGM ) and continuous glucose monitoring ( CGM ). Five diabetes patients simultaneously underwent FGM (FreeStyle Libre Pro) and CGM ( iP ro™2), and their glucose levels were compared with venous blood and capillary blood glucose levels. The range of daily venous blood glucose levels (30 measurements) was 70–245 mg/ dL , with a median of 138 mg/ dL . There were good correlations of glucose levels measured by FGM ( r 2 = 0.90, mean absolute relative difference 8.2 ± 5.6%), CGM ( r 2 = 0.86, mean absolute relative difference 9.2 ± 9.1%) and capillary blood ( r 2 = 0.87, mean absolute relative difference 7.2 ± 7.2%) with venous blood glucose levels. The accuracy of FGM measurements was also shown against CGM , with 99.9% of the FGM values (1,279 measurements) being within the Parkes error grid zones A and B. The results suggest that the accuracy of FGM is similar to that of CGM, and that FGM is a useful tool for determining daily glucose profile.

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Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

et al. 2018

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LeaderT here is a demand from regulators that new treatments for the management of hyperglycaemia in people with type 2 diabetes should not increase cardio vascular risk. 1,2 For most new therapies this will include the performance of a dedicated randomised-controlled cardiovascular outcomes trial (CVOT). This can be conducted prior to licensing, like the SUSTAIN-6 trial with semaglutide, 3 or post-licensing, like the LEADER trial with liraglutide. 4 The results of CVOTs with albiglutide, a once-weekly GLP-1 receptor agonist, and linagliptin, a DPP-4 inhibitor, were presented at the recent meeting of the European Association for the Study of Diabetes (EASD) in Berlin. 5,6 As there are now several completed trials with GLP-1 receptor agonists and DPP-4 inhibitors it is relevant to place the results of these studies in the context of the results of previous studies. Harmony OutcomesAlbiglutide is a once-weekly GLP-1 receptor agonist composed of two copies of modified human GLP-1 fused to human albumin. It was available for clinical use in the US and Europe from 2014. In the summer of 2017 the manufacturer GlaxoSmithKline announced that albiglutide would be withdrawn from the worldwide market by 2018 for economic reasons that were not detailed, and marketing ceased in July 2018. A lack of potency compared to other GLP-1 receptor agonists, 7 and the inconvenience to the patient of having to reconstitute the lyophilised powder with a diluent and wait 15-30 minutes before injection 8 may have contributed to the low use of albiglutide in countries where other onceweekly GLP-1 receptor agonists were available.Harmony Outcomes was a post-licensing CVOT comparing albiglutide and placebo in 9463 people with type 2 diabetes and established cardiovascular disease, including coronary vascular disease, cerebrovascular disease and peripheral arterial disease. 5 Other inclusion criteria included age over 40 years, and HbA1c over 7.0% (53mmol/mol). At baseline 70% of participants had coronary heart disease, 47% had a previous myocardial infarction and 20% were recorded as having baseline heart failure by their local clinical investigator. Subjects were followed for a median of 1.6 years and the primary outcome was major adverse cardiovascular events (MACE), a composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke.Subjects in the albiglutide arm had a statistically significant 22% reduction in MACE compared to the placebo group. This was despite one-quarter of the subjects discontinuing therapy during this short study. Of the components of the MACE outcome, myocardial infarction (fatal or non-fatal) was significantly reduced, with insignificant effects on stroke and cardiovascular death. The number of subjects needed to treat with albiglutide for 1.6 years to prevent one major adverse cardiovascular event was 50. In the placebo group there was as expected a greater use of sulphonylureas and insulin, including greater use of bolus insulin. Hypoglycaemia rates were lower with albiglutide, including le...

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A Multicenter Real-Life Study on the Effect of Flash Glucose Monitoring on Glycemic Control in Patients with Type 1 and Type 2 Diabetes

Abstract: This study shows that FCGM-based AGP with FreeStyle LibrePro is associated with significant reductions in A1c levels in both T1D and T2D. In addition, improvement in A1c levels was maintained across all age groups and in patients enrolled at different diabetes clinics in India.

Cited by 34 publications

References 14 publications

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

Accuracy of flash glucose monitoring in insulin‐treated patients with type 2 diabetes

Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

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