Aims: The FreeStyle Libre (FSL) flash glucose monitoring device was made available on the UK National Health Services (NHS) drug tariff in 2017. This national audit aims to explore the UK real world experience of FSL and the impact on glycaemic control.
Methods: Clinicians were invited to submit FSL user data to a secure web-based tool held within the NHS N3 network. Data were analysed from available initial submissions from the 60 out of 120 NHS hospital trusts registered for the audit. R3.5.0 was used for statistical analysis and T-test was used to compare the baseline and follow-up HbA1c. Within-person variations of HbA1c calculated adj-HbA1c-SD=SD/sq. Root [n/(n−1)].
Results: Data were available for 2,438 (2,348 people with type 1 diabetes) FSL users; age 34(IQR =19-51) years, 54% female, diabetes duration 14 (IQR=19-51) years, and BMI of 24(IQR=21-28) kg/m2 and participants had 10 (IQR=7-12) scans/day. The baseline HbA1c was 67.8(±17) (8.4%), and after a median follow-up of 6 months (n=625) HbA1c reduced to 61.8 (±14) (7.8%) mmol/l (P<0.0001)). HbA1c reduction was greater in those with initial HbA1c ≥69.4 (>8.5%) mmol/mol; HbA1c reduced from 85.8 mmol/mol (±15) (10%) to 73.1 mmol/mol (±15) (8.8%)). FSL use was also associated with reduced within-person HbA1c variability (5.37 pre-FSL vs. 3.15 post-FSL, P<0.0001). In the immediate 12 month period prior to FSL initiation, 5% patients reported a hospital admission related to hyperglycaemia/diabetic ketoacidosis. During the ongoing median follow-up of 6 months following FSL initiation this was 1%.
Conclusions: These initial FSL audit data demonstrate significantly improved glycaemic control, reduction in HbA1c variability and less hyperglycaemia related hospital admissions in the first 6 months follow-up. Data collection is ongoing. Further analyses with longer follow-up may confirm these findings and inform future clinical practice and policy.
H. Deshmukh: None. E.G. Wilmot: Advisory Panel; Self; Dexcom, Inc. Research Support; Self; Diabetes UK. Speaker's Bureau; Self; Abbott, Eli Lilly and Company, Novo Nordisk Inc., Sanofi. D. Bishop: None. D.W. Lipscomb: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. Stock/Shareholder; Self; ABCAM, EKF Diagnostics, GlaxoSmithKline plc., Renalytix AI PLC. R. Banatwalla: None. R. Zaidi: None. Z.V. Smith: None. L. Overend: Other Relationship; Self; Lilly Diabetes, Novo Nordisk Inc. S. Kamaruddin: None. C.M. Hall: None. J. Macfadyen: None. A. Kilvert: Advisory Panel; Self; Sanofi. R.E. Ryder: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Bioquest. C. Walton: Advisory Panel; Spouse/Partner; Celgene Corporation. Speaker's Bureau; Spouse/Partner; Leo Pharma, Novartis Pharmaceuticals Corporation. T. Sathyapalan: Speaker's Bureau; Self; Novo Nordisk Foundation. Other Relationship; Self; Bristol-Myers Squibb Company, Eli Lilly and Company, Sanofi-Aventis.
Association of British Clinical Diabetologists