Improved well-being and decreased disease burden after 1-year use of flash glucose monitoring (FLARE-NL4)

Fokkert, Marion J; Dijk, Peter van; Edens, Mireille A.; Barents, Eglantine; Mollema, J.; Slingerland, Robbert J.; Gans, Rijk O. B.; Bilo, Henk J. G.

doi:10.1136/bmjdrc-2019-000809

Cited by 116 publications

(89 citation statements)

References 10 publications

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“…We have also found a significant reduction in diabetes‐related hospitalizations following the use of FCGM, consistent with previously published observational studies, 20,26 as well as a significant reduction in overall internal medicine hospitalizations. Patients purchasing FCGM technology probably experienced lower glycemic variability, as reflected by decreased hospitalization both for hyper‐ and hypoglycemia.…”

Section: Discussionsupporting

confidence: 92%

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Tsur

Cahn

Israel

et al. 2020

Diabetes Metabolism Res

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BackgroundWe evaluated the impact of flash continuous glucose monitoring (FCGM) on glycemic control and healthcare burden in a large real‐world cohort of patients with type 1 diabetes (T1D) initiating FCGM technology.MethodsIn this retrospective cohort study, we included adults (age ≥18 years) with T1D from a large Health Maintenance Organization in Israel, who initiated FCGM during 2018. Primary outcomes included change in HbA1c ≥3 months following FCGM commencement and change in rate of internal‐medicine hospitalization. Additional outcomes included changes in glucose test strip purchases, diabetes related outpatient health care visits and hospitalization for diabetic ketoacidosis (DKA) and/or severe hypoglycemia.ResultsThe study included 3490 patients, followed for a median of 14 (inter‐quartile range 11‐15) months after FCGM commencement. Among 2682 patients with an HbA1c measured both at baseline and ≥3 months after FCGM initiation, average HbA1c declined from 8.1% ± 1.46% to 7.9% ± 1.31% (P < .001) at first measurement and was maintained during follow up. Specifically, in those with HbA1c ≥8%, a mean decline of 0.5% (P < .001) was observed. A clinically significant HbA1c reduction of ≥0.5% was experienced by 25.5% of the patients. The rate of internal medicine hospitalization, visits to primary care, or visits to endocrine/diabetes specialists in the period following FCGM commencement vs the 6 months prior was significantly reduced (P < .001). Hospitalization for DKA and/or hypoglycemia declined as well (P = .004).ConclusionsFCGM was associated with significant and durable improvement in glycemic control as well as reduced consumption of healthcare services.

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Section: Discussionsupporting

confidence: 92%

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Tsur

Cahn

Israel

et al. 2020

Diabetes Metabolism Res

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“…Worldwide, usage of continuous glucose monitoring and flash glucose monitoring is increasing 32 . Among users, improved treatment outcomes 33,34 and high treatment satisfaction are seen 35‐37 . However, adverse skin reactions to continuous glucose monitoring and/or insulin pumps have been reported as a persistent health issue affecting diabetes‐specific emotional distress among those affected 38 .…”

Section: Discussionmentioning

confidence: 99%

Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

et al. 2020

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Background Several cases of allergic contact dermatitis (ACD) to the glucose sensor FreeStyle Libre have been reported. Isobornyl acrylate (IBOA) and N,N‐dimethylacrylamide (DMAA) are known culprit allergens. Objectives To evaluate patients with suspected ACD to FreeStyle Libre in a standardized manner, present causative allergens, and assess patient‐reported implications. Methods A total of 15 patients with suspected ACD to FreeStyle Libre were patch tested with the Swedish baseline series and a new medical device series. IBOA and DMAA were tested at 0.1% and 0.3% in petrolatum (pet.). Readings were performed on day (D) 3 and D7. Background data, details on skin reactions, and associated implications were assessed using a questionnaire. Results Thirteen patients were sensitized to IBOA and four to DMAA. Two positive reactions to IBOA and one to DMAA were seen only at 0.3% concentration on D7. Median duration of sensor use before dermatitis onset was 6 months. Half the number of the patients took precautions in everyday life due to sensor‐related skin reactions. Six patients discontinued sensor usage. Conclusions Patients with suspected ACD to glucose sensors should be evaluated with a relevant patch test series containing IBOA and DMAA. Adding the 0.3% pet. concentration is recommended. The reading on D7 is necessary.

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“…Four studies showed that flash glucose monitoring improved glycemic control, as assessed by HbA1c, compared with prior to its use (Table 2 ) [ 20 – 23 ]. In the Dutch prospective registry study, estimated HbA1c decreased from 8.0% before use of flash glucose monitoring to 7.6% after 6 months of use ( P < 0.001) and remained steady at 7.6% at 12 months ( P < 0.001).…”

Section: Real-world Observational Studies In Mixed Populations Of T1dmentioning

confidence: 99%

A review of flash glucose monitoring in type 2 diabetes

Krakauer

Botero

Lavalle-Gonzalez

et al. 2021

Diabetol Metab Syndr

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Background Continuous glucose monitoring systems are increasingly being adopted as an alternative to self-monitoring of blood glucose (SMBG) by persons with diabetes mellitus receiving insulin therapy. Main body The FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, United Kingdom) consists of a factory-calibrated sensor worn on the back of the arm which measures glucose levels in the interstitial fluid every minute and stores the reading automatically every 15 min. Swiping the reader device over the sensor retrieves stored data and displays current interstitial glucose levels, a glucose trend arrow, and a graph of glucose readings over the preceding 8 h. In patients with type 2 diabetes (T2D) receiving insulin therapy, pivotal efficacy data were provided by the 6-month REPLACE randomized controlled trial (RCT) and 6-month extension study. Compared to SMBG, the flash system significantly reduced the time spent in hypoglycemia and frequency of hypoglycemic events, although no significant change was observed in glycosylated hemoglobin (HbA1c) levels. Subsequent RCTs and real-world chart review studies have since shown that flash glucose monitoring significantly reduces HbA1c from baseline. Real-world studies in both type 1 diabetes or T2D populations also showed that flash glucose monitoring improved glycemic control. Higher (versus lower) scanning frequency was associated with significantly greater reductions in HbA1c and significant improvements in other measures such as time spent in hypoglycemia, time spent in hyperglycemia, and time in range. Additional benefits associated with flash glucose monitoring versus SMBG include reductions in acute diabetes events, all-cause hospitalizations and hospitalized ketoacidosis episodes; improved well-being and decreased disease burden; and greater treatment satisfaction. Conclusion T2D patients who use flash glucose monitoring might expect to achieve significant improvement in HbA1c and glycemic parameters and several associated benefits.

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Improved well-being and decreased disease burden after 1-year use of flash glucose monitoring (FLARE-NL4)

Cited by 116 publications

References 10 publications

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

A review of flash glucose monitoring in type 2 diabetes

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