Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion

Moreno-Fernández, Jesús; Pazos-Couselo, Marcos; González-Rodríguez, María; Rozas, Pedro; Delgado, Manuel; Aguirre, Miguel; García-López, José Manuel

doi:10.1016/j.endien.2018.11.003

Cited by 5 publications

(8 citation statements)

References 26 publications

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“…The results of this study confirm what has already been shown in numerous trials [7][8][9][10][11][12][13][14][15]. The simplicity and ease of use of the FGM system which was confirmed by frequent scans on daily basis exactly according to the recommendations, even increasing slightly by the end of one year indicating high level of adherence and compliance resulting in the improvement of HbA1c.…”

Section: Discussionsupporting

confidence: 89%

“…There was a decrease in HbA1c in the entire cohort of patients occurring in the first 3 months with no further changes to the end of one year confirming that majority of improvement in glucoregulation is taking place at the very beginning of FGM implementation in glycemic management, supporting evidence of presently published observational trials [7][8][9][10][11][12][13][14][15]. As the FGM metrics were not available at baseline, data from T3 to 12 were analyzed showing a significant increase in the time spent in range (TIR) and significant decrease in time spent in hyperglycemia (TAR).…”

Section: Discussionsupporting

confidence: 74%

“…In the landmark RCTs of FGM efficacy a change in HbA1c has not been observed [1,2]. On the other hand, the majority of observational studies conducted in routine clinical practice have reported a significant reduction in HbA1c with the usage of FGM [7][8][9][10][11][12][13][14][15]. Furthermore, recently published studies suggested that patients with good glycemic control have no benefits from FGM use, while those with suboptimal control tend to reach significant improvement in HbA1c levels probably due to the higher motivation and empowerment of patients in therapeutic decision making [8,10,11,16].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…3–5 Subsequent real-world observational studies demonstrated improvements in glycemic control and quality of life, less disease burden and a decrease in the number of hospital admissions and days of work absenteeism. 1,6–11…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Subsequent real-world observational studies demonstrated improvements in glycemic control and quality of life, less disease burden and a decrease in the number of hospital admissions and days of work absenteeism. 1,[6][7][8][9][10][11] While the isCGM has shown its potential to reduce costs of T1D-related morbidities, the device incurs a certain cost. Therefore, cost-effectiveness assessment should be conducted.…”

Section: Introductionmentioning

confidence: 99%

Personalizing the Use of a Intermittently Scanned Continuous Glucose Monitoring Device in Individuals With Type 1 Diabetes: A Cost-Effectiveness Perspective in the Netherlands (FLARE-NL 9)

Emamipour

Dijk

Bilo

et al. 2022

J Diabetes Sci Technol

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Aims: Intermittently scanned continuous glucose monitoring (isCGM) is a method to monitor glucose concentrations without using a finger prick. Among persons with type 1 diabetes (T1D), isCGM results in improved glycemic control, less disease burden and improved health-related quality of life (HRQoL). However, it is not clear for which subgroups of patients isCGM is cost-effective. We aimed to provide a real-world cost-effectiveness perspective. Methods: We used clinical data from a 1-year nationwide Dutch prospective observational study (N = 381) and linked these to insurance records. Health-related quality of life was assessed with the EQ-5D-3L questionnaire. Individuals were categorized into 4 subgroups: (1) frequent hypoglycemic events (58%), (2) HbA1c > 70 mmol/mol (8.5%) (19%), (3) occupation that requires avoiding finger pricks and/or hypoglycemia (5%), and (4) multiple indications (18%). Comparing costs and outcomes 12 months before and after isCGM initiation, incremental cost-effectiveness ratios (ICERs) were calculated for the total cohort and each subgroup from a societal perspective (including healthcare and productivity loss costs) at the willingness to pay of €50,000 per quality-adjusted life year (QALY) gained. Results: From a societal perspective, isCGM was dominant in all subgroups (ie higher HRQoL gain with lower costs) except for subgroup 1. From a healthcare payer perspective, the probabilities of isCGM being cost-effective were 16%, 9%, 30%, 98%, and 65% for the total cohort and subgroup 1, 2, 3, and 4, respectively. Most sensitivity analyses confirmed these findings. Conclusions: Comparing subgroups of isCGM users allows to prioritize them based on cost-effectiveness. The most cost-effective subgroup was occupation-related indications, followed by multiple indications, high HbA1c and the frequent hypoglycemic events subgroups. However, controlled studies with larger sample size are needed to draw definitive conclusions.

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Chitosan Based Hybrid Polymeric Systems in Diabetes Monitoring

Kaur¹,

Neelam²,

Hajam³

et al. 2023

Biological and Medical Physics, Biomedical Engineering

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Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion

Cited by 5 publications

References 26 publications

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

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

Personalizing the Use of a Intermittently Scanned Continuous Glucose Monitoring Device in Individuals With Type 1 Diabetes: A Cost-Effectiveness Perspective in the Netherlands (FLARE-NL 9)

Chitosan Based Hybrid Polymeric Systems in Diabetes Monitoring

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