Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization in the Association of British Clinical Diabetologists (ABCD) Nationwide Audit.

Deshmukh, Harshal, Wilmot, Emma G, Gregory, Robert, Barnes, Dennis, Narendran, Parth, Saunders, Simon, Furlong, Niall, Kamaruddin, Shafie, Banatwalla, Rumaisa, Herring, Roselle, Kilvert, Anne, Patmore, Jane, Walton, Chris, Ryder, Robert E J and Sathyapalan, Thozhukat (2020) Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization in the Association of British Clinical Diabetologists (ABCD) Nationwide Audit. Diabetes care. ISSN 1935-5548. Available through UHB Open Athens

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Abstract

OBJECTIVE

The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions.

RESEARCH DESIGN AND METHODS

Clinicians from 102 NHS hospitals in the U.K. submitted FSL user data, collected during routine clinical care, to a secure web-based tool held within the NHS N3 network. The and Mann-Whitney tests were used to compare the baseline and follow-up HbA and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA following the use of FSL. Within-person variations of HbA were calculated using [Formula: see text].

RESULTS

Data were available for 10,370 FSL users (97% with type 1 diabetes), age 38.0 (±18.8) years, 51% female, diabetes duration 16.0 (±49.9) years, and BMI of 25.2 (±16.5) kg/m (mean [±SD]). FSL users demonstrated a -5.2 mmol/mol change in HbA, reducing from 67.5 (±20.9) mmol/mol (8.3%) at baseline to 62.3 (±18.5) mmol/mol (7.8%) after 7.5 (interquartile range 3.4-7.8) months of follow-up ( = 3,182) ( < 0.0001). HbA reduction was greater in those with initial HbA ≥69.5 mmol/mol (>8.5%), reducing from 85.5 (±16.1) mmol/mol (10%) to 73.1 (±15.8) mmol/mol (8.8%) ( < 0.0001). The baseline Gold score (score for hypoglycemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) ( < 0.0001) at follow-up. A total of 53% of those with a Gold score of ≥4 at baseline had a score <4 at follow-up. FSL use was also associated with a reduction in diabetes distress ( < 0.0001). FSL use was associated with a significant reduction in paramedic callouts and hospital admissions due to hypoglycemia and hyperglycemia/diabetic ketoacidosis.

CONCLUSIONS

We show that the use of FSL was associated with significantly improved glycemic control and hypoglycemia awareness and a reduction in hospital admissions.

Item Type:	Article
Additional Information:	Available through UHB Open Athens
Subjects:	WK Endocrine system. Endocrinology
Divisions:	Ambulatory Care > Diabetes
Related URLs:	https://pubmed.ncbi.nlm.nih.gov/32669277...
Depositing User:	Beth Connors
Date Deposited:	24 Jul 2020 15:38
Last Modified:	24 Jul 2020 15:38
URI:	http://www.repository.uhblibrary.co.uk/id/eprint/3301

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