Population-based study on the implementation of flash glucose monitoring and severe hypoglycemia in adults with type 1 diabetes

• Published in: Diabetes technology & therapeutics
• Main Authors: Rodríguez de Vera Gómez, Pablo, Mayoral Sánchez, Eduardo, Vilches Arenas, Ángel, Ravé-García, Reyes, De la Cal Ramírez, Manuel, Umpierrez, Guillermo, Martínez-Brocca, Mª Asunción
• Format: Journal Article
• Language: English
• Published: United States 04.07.2024
• ISSN: 1557-8593
• DOI: 10.1089/dia.2024.0201

Objective We analyzed the effect of implementing a flash glucose monitoring (FGM) technology in a public healthcare system with universal coverage on the rate of severe hypoglycemia requiring urgent care in adults with type 1 diabetes mellitus (T1DM). Methods Using a comprehensive regional dataset, we extracted emergency care codes with hypoglycemia in individuals with T1DM who initiated the use of FGM in Andalucia, Spain from 01/01/2020 to 12/31/2021. Severe hypoglycemia was defined as a confirmed blood glucose <70 mg/dl, which required the urgent dispatch of an emergency medical service (EMS) for on-site management. We compared hypoglycemic events reported in the 12 months before and after the initiation of FGM to determine the population incidence rates. Results A total of 13,616 participants with a mean age of 43.7±13.5 years were included. The follow-up periods were 23.4 and 24.8 months before and after FGM. There were 969 and 737 cases of hypoglycemia before and after the initiation of FGM. The baseline incidence rate was 358.58 episodes per 10,000 person-years, which decreased to 260.9 at the end of the follow-up (rate-ratio 0.72 [0.66; 0.80]). The reduction in hypoglycemia was significant in individuals aged ≥60 years (rate-ratio 0.40 [0.28; 0.55]) and males (0.64 [0.56; 0.72]). In addition, there was a reduction in the overall median HbA1c of -0.35% (95% CI [-0.38; -0.33], p<0.001) Conclusion The implementation of FGM systems in a public healthcare system as a provision for adults with T1DM was associated with significant reductions in the rate of severe hypoglycemic events that required urgent EMS care.