The development of devices that free patients from finger piercing and from using of test-strips in diabetes control, can demonstrate us the real daily need for glycemic self-control in patients with T1D on insulin pump therapy.
58 adult patients with T1D undergoing insulin pump therapy used the FreeStyle Libre flash glucose monitoring systems (FGM) over the period of 4-15 days (the first and the last days (incomplete) were not analyzed) in both inpatient and outpatient care, followed by a retrospective assessment of the frequency of glycemic scans per day.
The average number of glycemia scans on the 1-st day was 27.5±22.4 times, on the 7-th day - 27.8±21.1 times, on the 14-th day - 25.8±18.7 times (p>0.05). The average number of scans per day during the first six days was 29.1±24.5 times, during the next seven days – 27.3±26.1 times (p>0.05). The average number of scans during 13 days – 28.2 ±25.3 times. Over all period of the study: the average glucose level – 8.8±2.1 mmol/l, time in range (TIR) – 47.6±18.6%, above TIR – 42.5±21.8%, below TIR – 9.7±10.4%, the average number of hypoglycemia events per day – 11.9±9.2, the average duration – 94.3±46.3 min. Baseline HbA1c was at 8.2±1.2%. Prognostic HbA1c by FreeStyle Libre at the end of the study – 7.2±1.5%.
The obtained results show that the recommended standard glycemia self-control frequency at least 4 times a day, is actually 7 times lower than the real need in patients with T1D for optimization of the pump insulin therapy.