Presenter of 6 Presentations
Continuous glucose monitoring accuracy and performance: impact on clinical decision making
Remaining barriers and current outcomes in a changing world
Q&A
Q&A and closing remarks
Connected pens: Needs and expectations
Abstract
Abstract Body
Connected insulin pens are the latest technology to be introduced to the diabetes clinic. These pens use Bluetooth or Near Field Communication to transfer insulin dosing data from the pen to an app or online platform, allowing for the review of both glucose an insulin data in the clinic. This lecture will explore the concept of connected pens, unmet needs and expectations of both health care professionals and people living with diabetes. Just a decade ago, paper diaries were central to an effective diabetes consultation. They contained information on insulin doses, glucose levels and carbohydrate intake to enable informed shared decision making. Fast forward 10 years and the diabetes consultation has evolved with paper diaries largely replaced with uploaded or ‘in the cloud’ glucose data. For those on insulin pumps the ability to have the glucose, insulin and carbohydrate data available to review is an advantage. However, this data is not readily available for those on multiple daily injections. A data gap exists between multiple daily injection and insulin pump therapies. Connected pens bridge this gap by providing insulin data alongside glucose data, essential for optimisation. For those living with diabetes, connected pens may support therapy and behaviour change, for example, providing insight into the impact of mealtime insulin timing on postprandial glucose levels or the ability to identify missed insulin doses. This new technology is promising. Future feedback from both people living with diabetes and the health care professionals supporting them will determine their future role in diabetes services.
Flash glucose monitoring with the FreeStyle Libre 2: Results from the FLASH-UK randomised controlled trial (on behalf of the Study group)
Abstract
Abstract Body
Objectives
To evaluate whether intermittently scanned continuous glucose monitoring (isCGM) with optional alarms (FreeStyle Libre 2) improves glycaemia as measured by HbA1c and sensor-based gluco-metrics, patient reported outcome measures (PROMS) and cost-effectiveness compared with self-monitoring of blood glucose (SMBG).
Design
Flash UK is a multicenter, open-label, two arm, parallel, randomised controlled trial delivered in 7 specialist hospital diabetes clinics and 1 primary care centre.
Participants
156 people with Type 1 diabetes, age 16 years and over treated with either multiple daily insulin injections or insulin pump therapy with HbA1c 7.5%-11% were randomised.
Interventions
Participants were randomised (1:1) to the FreeStyle Libre 2 (n=72) or standard care with SMBG (n=69). Participants were reviewed at 4, 12 and 24 weeks post-randomisation. Education and treatment optimisation was provided to both groups at randomisation, 4 and 12 weeks. Participants in the SMBG arm wore blinded glucose sensor (Freestyle Libre Pro) during the last 2 weeks of the study; all participants wore a 2-week blinded sensor prior to randomisation. All study visits were conducted either in-person or virtually owing to the COVID-19 pandemic.
Main outcome measures
The primary outcome was HbA1c at 24 weeks, analysed by intention to treat. Secondary outcomes included glucose time in range (3.9 to 10mmol/l), time below and above range and glucose variability. PROMS included EQ-5DL-5L, Type 1 Diabetes Distress Scale, Diabetes fear of injecting and self-testing, Diabetes Eating Problem Survey, Diabetes Treatment Satisfaction, Patient Health Questionnaire and The Glucose Monitoring Satisfaction Survey. Economic evaluation included healthcare resource use, insulin usage and Freestyle Libre 2 utilisation.
Results & Conclusion
Results and conclusions will be presented during the 15th International Conference on Advanced Technologies & Treatments for Diabetes, April 27 to 30th Barcelona, Spain and Online.