Aim: The FreeStyle Libre (FSL) flash glucose monitoring device was made available on the UK National Health Services (NHS) drug tariff in 2017. This study aims to explore the UK real-world experience of FSL and the impact on glycaemic control, hypoglycaemia, diabetes-related distress and hospital admissions.

Methods: Clinicians from 102 National Health Service hospitals in the United Kingdom submitted FSL user data, collected during routine clinical care, to a secure web-based tool. T-tests and Mann-Whitney-U tests were used to compare the baseline and follow-up HbA1c and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA1c following the use of FSL. Within-person variations of HbA1c calculated adj-HbA1c-SD=SD/sq. Root [n/(n−1)].

Results: Data were available for 10,370 (97% with type 1 diabetes) FSL users; age 38 (±18.7) years, 54% female, diabetes duration 16 (±49) years, and BMI of 25.2 (±16.5) kg/m2. The baseline HbA1c was 69.8 (±18.2) (8.5%), and after a mean follow-up of 7.6 (±23)months (n=3182) HbA1c reduced to 62.3 (±18.5) (7.9%) mmol/l (P<0.0001)). HbA1c reduction was greater in those with initial HbA1c ≥69.5 (>8.5%) mmol/mol, HbA1c reduced from 85.5mmol/mol (±16.07) (10%) to 73.1 mmol/mol (±15.8) (8.8%)) (P<0.0001). The baseline Gold score (score for hypoglycaemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) (P<0.0001) at follow-up. 53% of those with a Gold score of ≥4 at baseline, regained hypoglycaemic awareness at follow-up. FSL use was also associated with a reduction in diabetes distress (P<0.0001). Use of FSL was associated with significantly reduced paramedic callouts and hospital admissions due to hypoglycaemia and to hyperglycaemia/Diabetic Ketoacidosis (DKA).

Conclusion: We show that the use of FSL was associated with significantly improved glycaemic control and hypoglycaemia awareness, and a reduction in hospital admissions.


H. Deshmukh: None. E.G. Wilmot: Advisory Panel; Self; Abbott, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic. Speaker’s Bureau; Self; Abbott, Eli Lilly and Company, Insulet Corporation, Novo Nordisk Inc., Sanofi. J. Patmore: None. C. Walton: Speaker’s Bureau; Spouse/Partner; Celgene, LEO Pharma, Novartis Pharmaceuticals Corporation. R. Herring: None. R.E. Ryder: Consultant; Self; GI Dynamics Inc. Other Relationship; Self; Novo Nordisk A/S. T. Sathyapalan: Research Support; Self; Amgen, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S. Other Relationship; Self; Ipsen Biopharmaceuticals.

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