Previous studies showed results of flash glucose monitoring (FreeStyle LibreTM) in European countries. This study evaluated real-world impact of device use and glucose metrics using a cross-sectional observational design in a developing country - Brazil. A server collected de-identified data from readers, and completed sensors (>120 hours of operation) were analysed. Comparison of 1,569,588 sensors (237,747 readers) worldwide were made with 57,713 sensors (8,979 readers) from Brazil. Readers were divided into 10 rank-ordered groups by daily scan rate. Users worldwide performed a mean (±SD) of 13.2±8.9 daily glucose scans and a rate of 13.5±9.1/day in Brazil (p=0.002). Time in range (70-180 mg/dL) increased from 13.5 to 16.2 h/day (20% increase, p<0.001) comparing the lowest and highest scan groups in Brazil, with a similar association worldwide (12.0 to 16.3 h/day; 35% increase; p<0.001). Time in hyperglycemia decreased from 10.6 to 6.4 h/day (40% decrease, p<0.001) comparing low with high frequency users worldwide. Brazil users had a similar decrease, though the lowest scan group was 90-minutes lower (9.2 and 6.4 h/day; 30% decrease; p<0.001). Similar daily scan rates were observed in Brazil and worldwide, and those users having the highest daily scans also had the most time in range and least time in hyperglycemia. This is the first study showing that a developing country in Latin America can also benefit from flash glucose monitoring.

L.P. Calliari: Board Member; Self; Abbott. Speaker's Bureau; Self; Novo Nordisk Inc.. Board Member; Self; Sanofi. Speaker's Bureau; Self; Medtronic, Roche Diagnostics Corporation. Board Member; Self; Eli Lilly and Company. Y. Xu: Employee; Self; Abbott. S. Jangam: Employee; Self; Abbott. G. Hayter: Employee; Self; Abbott. T. Dunn: Employee; Self; Abbott.

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