Real-world benefits of flash glucose monitoring confirmed in high-risk cases
medwireNews: Flash glucose monitoring significantly reduces time in hyperglycemia or hypoglycemia in people with diabetes at high risk for either outcome, with the benefit sustained for at least 6 months, real-world study data show.
Individuals with the highest frequency of scanning appeared to benefit the most by “minimizing hyperglycemic exposure,” report Sujit Jangam (Abbott Laboratories, Alameda, California, USA) and colleagues in BMJ Open Diabetes Research & Care.
The analysis included glucose results from 6802 FreeStyle Libre flash glucose monitors (Abbott Diabetes Care, Alameda, California).
During 6 months of use, time spent in hyperglycemia (blood glucose >240 mg/dL; 13.3 mmol/L) fell significantly from an average 6.07 hours/day in the first 14 days to 5.73 hours/day in the last 14 days among individuals at high risk for hyperglycemia (ie, those in the highest tertile of time spent in hyperglycemia during the first 14 days).
When these individuals were stratified according to tertiles of scanning frequency, the researchers found that the reduction in time spent in hyperglycemia remained significant for high (0.81 hours/day) and medium (0.37 hours/day) frequency scanners, at 0.81 and 0.37 hours/day, respectively, but not for low frequency scanners.
The researchers also found that there was a “modest” but statistically significant increase in time spent in hypoglycemia (<70 mg/dL; 3.9 mmol/L) of 5–7 minutes among the high and medium frequency scanners, but no significant change among the low frequency scanners.
Individuals at high risk for hypoglycemia also benefited from the flash monitoring system, with the time spent at a blood glucose level below 70 mg/dL falling from a mean of 200 minutes/day in the first 14 days to 154 minutes/day in the last 14 days. The time spent at or below 54 mg/dL (3.0 mmol/L) fell from 90 to 69 minutes/day.
Jangam and team observed no difference in the magnitude of the reduction in time spent in hypoglycemia according to the frequency of scanning but found that low frequency scanners experienced a greater increase in time spent in hyperglycemia (2.82–3.94 hours/day) than high frequency scanners (1.33–1.67 hours/day).
“It can be inferred from these results that individuals address the glycemic issue that is most relevant to them even at the cost of worsening other glycemic metrics,” the researchers remark.
Overall, the reduction in time spent in hypoglycemia occurred faster than that for hyperglycemia, but the total improvement attained in both groups was achieved within the first 2 months and sustained for the remaining 4 months.
The investigators also report that, overall, scanning frequency was initially high, at approximately 27 scans on the first day, but gradually fell to approximately 15 scans per day at around 2 months and for the rest of the study period. Furthermore, capillary blood glucose testing remained stable at 0.75 tests/day throughout the study, “indicating that individuals show confidence in and continue to rely on the system.”
Jangam et al conclude that their findings “show that flash glucose monitoring, under real-life conditions, significantly improves glucose control in subjects at high risk of dysglycemia.”
By Laura Cowen
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