Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion

• Published in: Endocrinologia, diabetes y nutricion Vol. 65; no. 10; pp. 556 - 563
• Main Authors: Moreno-Fernandez, Jesus, Pazos-Couselo, Marcos, González-Rodriguez, Maria, Rozas, Pedro, Delgado, Manuel, Aguirre, Miguel, Garcia-Lopez, Jose Manuel
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.12.2018
• Subjects: Treatment; Insulin pump; Diabetes mellitus tipo 1; Tratamiento; Bomba de insulina; Flash; Monitorización de la glucosa intersticial; Interstitial glucose monitoring; Type 1 diabetes mellitus
• ISSN: 2530-0172; 2530-0180
• DOI: 10.1016/j.endinu.2018.04.003

To analyze the clinical impact of the Flash glucose monitoring system in patients with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). A 24-week retrospective cohort study in CSII-treated T1DM patients exposed (1:1) to the Flash glucose monitoring system vs. self-monitoring of capillary blood glucose (SMBG). The primary outcome was the difference in hemoglobin A1c (HbA1c) levels between both groups at the end of the study. Thirty-six patients with a mean age of 38.2 years (range 22-55) and a mean T1DM duration of 20.9±7.8 years, treated with CSII for 7.1±5.4 years, were enrolled into the study. At the end of the study, mean HbA1c levels improved in patients in the Flash group (7.1±0.7 vs. 7.8±1.0, p=0.04). Only the Flash group showed a significant decrease in HbA1c levels of -0.4% (95% CI, -0.6, -0.2; p=0.004) during follow-up. Flash patients captured 93.9% of data through 17.8±9.9 scans daily. In fact, the Flash cohort showed a three-fold increase in daily self-monitoring of glucose, while daily frequency of SMBG decreased during the study (-1.8 tests/24h (95% CI -3, -0.7; p=0.01). No safety issues related to Flash use were recorded. The Flash glucose monitoring system is a novel approach to improve blood glucose control in CSII-treated T1DM patients. Randomized controlled trials are needed to assess the effectiveness of this system in CSII-treated T1DM patients.