The challenges of caring for diabetes in teenagers and young adults are well known. We analyzed two research studies (IMPACT and SELFY) that evaluated FreeStyle LibreTM Flash Glucose Monitoring System as a replacement for self-monitoring of blood glucose (SMBG), looking specifically at outcomes in patients aged 13-24 years. IMPACT enrolled 241 patients with well controlled type 1 diabetes (T1DM), HbA1c 6.74±0.56% (50.1±6.1 mmol/mol), age 43.7±13.9 years (mean±SD) into a 6 month European RCT (23 sites). The control group (n=121) used SMBG and the intervention group used FreeStyle Libre for self-management. Of the 241 patients, 19 were aged 18-24 years. SELFY enrolled 76 young people aged 10.3±4.0 years (mean±SD), baseline HbA1c 7.9±1.0% (62.9±11.1 mmol/mol) into a 10 week single arm European study (10 sites). The study consisted of 2 weeks baseline masked (blinded) wear, followed by 8 weeks open use. Of the 76 patients, 25 were aged 13-17 years. IMPACT study results at 6 months showed no significant interaction of age with treatment group for the primary endpoint of time in hypoglycemia <70 mg/dL. For the younger adults, time in range (TIR) (70-180 mg/dL) significantly increased by 2.9±0.89 hours/day (mean±SE); p=0.0055. Time in hyperglycemia (>180 mg/dL) also significantly improved with a reduction of 2.40±0.834 hours/day (mean±SE); p=0.0113. Intervention group patients scanned the sensor on average 11.3 times daily. Teenagers in the SELFY study significantly improved the primary endpoint of TIR (70-180 mg/dL) by 1.2±2.5 hours/day (mean±SD), p=0.0254. HbA1c also significantly improved, -0.7±0.6%, p<0.0001. Time in hyperglycemia (>180 mg/dL) significantly reduced by -1.7±2.9 hours/day, p=0.0093, no statistically significant changes were observed in hypoglycemia (time<55 mg/dL, baseline 0.7±1.0 hours/day). Scan frequency of FreeStyle Libre was on average 9.7 times daily. The IMPACT and SELFY studies both demonstrated improvements in glycemic control in the teenager and young adult age groups.

Disclosure

F. Campbell: Research Support; Self; Abbott. Consultant; Self; Eli Lilly and Company, Novo Nordisk A/S, Johnson & Johnson Diabetes Institute, LLC., Sanofi, Medtronic, Roche Diabetes Care Health and Digital Solutions. J. Bolinder: Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S, Eli Lilly and Company.

© 2018 by the American Diabetes Association.
2018
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