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

• Published in: BMJ open diabetes research & care Vol. 7; no. 1; p. e000809
• Main Authors: Fokkert, Marion, van Dijk, Peter, Edens, Mireille, Barents, Eglantine, Mollema, Jeanine, Slingerland, Robbert, Gans, Reinold, Bilo, Henk
• Format: Journal Article
• Language: English
• Published: England American Diabetes Association 09.12.2019; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Absenteeism; continuous glucose monitoring; Cooperation; Diabetes; Emerging Technologies, Pharmacology and Therapeutics; flash glucose monitoring; freestyle libre; Glucose; Glucose monitoring; Hospitalization; Hospitals; Hypoglycemia; Insulin; Monitoring systems; patient reported outcome measures; Quality of life; Questionnaires; type 1 diabetes; Well being; Netherlands; patient reported outcome measures; type 1 diabetes; flash glucose monitoring; freestyle libre; continuous glucose monitoring
• ISSN: 2052-4897; 2052-4897
• DOI: 10.1136/bmjdrc-2019-000809

IntroductionThe FreeStyle Libre is a flash glucose monitoring (FSL-FGM) system. Compared with finger-prick based self-monitoring of blood glucose, FSL-FGM may provide benefits in terms of improved glycemic control and decreased disease burden.MethodsProspective nationwide registry. Participants with diabetes mellitus (DM) used the FSL-FGM system for a period of 12 months. End points included changes in HbA1c, hypoglycemia, health-related quality of life (12-Item Short Form Health Surveyv2 (SF-12v2) and 3-level version of EuroQol 5D (EQ-5D-3L)), a specifically developed patient-reported outcome measures (PROMs) questionnaire, diabetes-related hospital admission rate and work absenteeism. Measurements were performed at baseline, and after 6 months and 12 months.Results1365 persons (55% male) were included. Mean age was 46 (16) years, 77% of participants had type 1 DM, 16% type 2 DM and 7% other forms. HbA1c decreased from 64 (95%CI 63 to 65) mmol/mol to 60 (95%CI 60 to 61) mmol/mol with a difference of −4 (95% CI −6 to 3) mmol/mol. Persons with a baseline HbA1c >70 mmol/mol had the most profound HbA1c decrease: −9 (95% CI −12 to to 5) mmol/mol. EQ-5D tariff (0.03 (95%CI 0.01 to 0.05)), EQ-VAS (4.4 (95%CI 2.1 to 6.7)) and SF-12v2 mental component score (3.3 (95%CI 2.1 to 4.4)) improved. For most, PROMs improved. Work absenteeism rate (/6 months) and diabetes-related hospital admission rate (/year) decreased significantly, from 18.5% to 7.7% and 13.7% to 2.3%, respectively.ConclusionsReal world data demonstrate that use of FSL-FGM results in improved well-being and decreased disease burden, as well as improvement of glycemic control.