Ghasem Yadegarfar1,2, Simon G Anderson3, Zohaib Khawaja4, Gabriela Cortes5, Kathryn Leivesley6, Ann Metters6, Linda Horne6, Tom Steele6, Adrian H Heald1,4. 1. The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, UK. 2. Heart Failure Research Center, Cardiovascular Research Institute, & School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. 3. University of the West Indies, Cave Hill Campus Barbados, Barbados. 4. Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK. 5. High Speciality Regional Hospital of Ixtapaluca, Mexico City, Mexico. 6. Vernova Healthcare, Watersgreen Medical Centre, Macclesfield, UK.
Abstract
INTRODUCTION: Many people with type 1 diabetes continue to run high HbA1c levels with associated elevated risk of cardiovascular events and increased mortality. We describe here how use of the FreeStyle Libre flash monitor has improved the glycaemic control of many people with type 1 diabetes where the new technology has been intensively deployed. METHODS: We report the outcomes of 92 consecutive adults (18 years of age or more) with type 1 diabetes who have begun using the FreeStyle Libre flash glucose monitor in East Cheshire, UK. Initiation was with education and support from one of the diabetes specialist nurses. An HbA1c of 60 mmol/mol (7.6%) was taken as the threshold for suboptimal glycaemic control. RESULTS: The mean cohort age was 43 years for men and 39 years for women (overall range 17-83 years). In 92 consecutive users, HbA1c decreased by an average of 10.7 mmol/mol (0.98%) after 3 months, and by 16.1 mmol/mol (1.47%) after 6 months. There was also a narrowing of the distribution of HbA1c, with many fewer people running high HbA1c ≥80 mmol/mol (9.5%). After the 6-month follow-up, two 2/92 users did not wish to continue with the monitoring. CONCLUSION: Flash glucose monitoring has great potential for the management of type 1 diabetes in the adult population and improving metabolic control/quality of life for people across the world. The technology provides significantly more data than the intermittent results obtained by traditional subcutaneous blood glucose monitoring, which may not capture intervals of extreme variability or nocturnal events.
INTRODUCTION: Many people with type 1 diabetes continue to run high HbA1c levels with associated elevated risk of cardiovascular events and increased mortality. We describe here how use of the FreeStyle Libre flash monitor has improved the glycaemic control of many people with type 1 diabetes where the new technology has been intensively deployed. METHODS: We report the outcomes of 92 consecutive adults (18 years of age or more) with type 1 diabetes who have begun using the FreeStyle Libre flash glucose monitor in East Cheshire, UK. Initiation was with education and support from one of the diabetes specialist nurses. An HbA1c of 60 mmol/mol (7.6%) was taken as the threshold for suboptimal glycaemic control. RESULTS: The mean cohort age was 43 years for men and 39 years for women (overall range 17-83 years). In 92 consecutive users, HbA1c decreased by an average of 10.7 mmol/mol (0.98%) after 3 months, and by 16.1 mmol/mol (1.47%) after 6 months. There was also a narrowing of the distribution of HbA1c, with many fewer people running high HbA1c ≥80 mmol/mol (9.5%). After the 6-month follow-up, two 2/92 users did not wish to continue with the monitoring. CONCLUSION: Flash glucose monitoring has great potential for the management of type 1 diabetes in the adult population and improving metabolic control/quality of life for people across the world. The technology provides significantly more data than the intermittent results obtained by traditional subcutaneous blood glucose monitoring, which may not capture intervals of extreme variability or nocturnal events.
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