Clinical trial demonstrate improved glycemic control, namely reduced time in hypoglycemia with flash glucose monitoring (FGM); however real-life conditions can modify this scenario.
Aim: To examine real world use and glycemic control following a standardized initiation process of FGM.
Individuals aged >18 years with type 1 diabetes (T1D) were prospectively recruited from diabetes outpatient clinic. Pregnancy, diabetic ketoacidosis or use of continuous glucose monitoring (CGM) in the previous 6 months were exclusion criteria. FGM metrics from baseline (first 14 days of use) and 6 months were compared, using the glycemic control targets established in the 2019 ATTD consensus.
Thirty-five individuals were included (65.7% males); median age was 48(40-60) years, diabetes duration 23(14-33) years; 94.3% were on multiple daily injections, 5,7% on pump. At baseline, median time below 70mg/dL was 4.0(2.5-9.0) % and 40% of the individuals had a time below 70mg/dL ≤4%, compared to 3(1-9)% (p=0.209) and 51.4% (p=0.206), respectively, at 6 months. Median time in hypoglycemia was 98(72.5-122.5) minutes and 75(54.0-113.0) minutes at baseline and at 6 months, respectively (p=0.022).
There was a significant decrease in the median coefficient of variation (CV) [42.8(37.3-46.4) to 38.7(34.2-45.0), p <0.001]. Median TIR (time in range) was 50(40-60)% at baseline and 47(35-55)% at 6 months (p=0.02) and mean HbA1c (chromatography method) was 7.67±1.06% and 7.74± 1.12% (p=0.509) respectively.
At 6 months, median time in hypoglycemia and CV was reduced by 23.5% and 4.1, respectively, with no deterioration on HbA1c. Our data support the benefit of FGM on glucose control in T1D.