Emanuele Bosi, Italy

San Raffaele Hospital Medicine
Emanuele Bosi is a physician scientist, Professor of Internal Medicine (formerly of Endocrinology) at the San Raffaele Vita Salute University and Head of the General Medicine, Diabetes and Endocrinology at the San Raffaele Hospital, Milan. Emanuele Bosi graduated in Medicine in 1979 from the University of Milan, Italy, where he also received a specialty diploma in diabetes and metabolic diseases and subsequently in clinical immunology. During his career he has received clinical training in Milan and worked as a clinical investigator at the Edouard Herriot Hospital in Lyon, France, and the University College and St Bartholomew’s Hospitals in London, UK. His research activity has been entirely devoted to diabetes, with focus on pathogenesis, prediction and prevention of type 1 diabetes, new drugs for type 2 diabetes, innovative technologies for blood glucose monitoring and prevention of hypoglycemia. Noteworthy, Dr. Bosi is Principal Investigator of the International TrialNet and INNODIA Clinical Center at the San Raffaele Hospital, conducting intervention trials in recent‐onset type 1 diabetes and in subjects at risk of the disease, as well as further defining the natural history of the disease and its pathophysiology.

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ORAL PRESENTATION SESSION

EFFECT OF FLASH GLUCOSE MONITORING ON GLYCAEMIC CONTROL IN TYPE 2 DIABETES COMPARED TO SMBG; A PROSPECTIVE OBSERVATIONAL STUDY FROM ITALY

Abstract

Background and Aims

This prospective, observational cohort study was designed to measure the change in HbA1c over 3-6 months in adults with T2DM on a basal-bolus insulin regimen using the FreeStyle Libre Flash Glucose Monitoring SystemTM compared to self-monitoring blood glucose (SMBG), in a real-world setting.

Methods

A total of 322 patients (109 intervention, 213 control) with T2DM from 16 hospital sites in Italy were enrolled. To minimise selection bias, all eligible FreeStyle Libre users were included, matched to SMBG patients by HbA1c (within ±0.5%) and study site. The study population included adults on a basal-bolus insulin regimen for ≥1 year, with HbA1c 8.0-12.0% (64-108 mmol/mol), who were either new to FreeStyle Libre and planned to use it for ≥3 months (intervention) or planned to continue with SMBG (control) in a 1:2 ratio. On average, HbA1c was 8.9±0.8% (73.9±8.8 mmol/mol), age 67.2±10.0 years, BMI 30.5±6.5 kg/m2 and average duration of insulin use 8.6±6.6 years (mean±SD), 56.2% were male.

Results

After 3-6 months, 234 complete case patients (83 intervention, 151 control) demonstrated significantly reduced HbA1c for FreeStyle Libre users compared to SMBG by 0.30% (95%CI: -0.53, -0.07), p=0.0113. Considering all 322 patients (109 intervention, 213 control), with imputed missing HbA1c values, HbA1c was also significantly reduced for FreeStyle Libre users vs. SMBG by 0.28% (95%CI: -0.50, -0.05), p=0.0199. The difference remains statistically significant after adjusting for the confounders.

Conclusions

This real-world, prospective cohort study concluded that people with T2DM on basal-bolus insulin, using FreeStyle Libre for 3-6 months significantly reduced HbA1c compared to SMBG.

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