Background: The Freestyle Libre Flash Glucose Scanning System (FGS) is a glucose sensing technology device for people with diabetes to monitor plasma glucose levels, reducing the need for routine fingerpricks. The device is worn on the upper arm and produces graphs displaying glucose levels over a period of time. Trials of the Freestyle Libre device have been utilised at Nottingham Childrens Hospital (NCH), providing the device is used safely. Potential for most benefit includes patients who have difficulty completing regular fingerprick tests, impaired awareness of hypoglycaemia and patients who undertake glucose monitoring >8 times a day. This audit aims to evaluate the use of the Freestyle Libre device in children and young people attending NCH diabetes clinics to assess its effectiveness in improving diabetes control measured by HbA1c reduction.
Methods: Patients attending the paediatric clinic who had used the FGS device between April 2016 and November 2017 were identified. Data was collected retrospectively from patient records, specifically the Diamond (diabetes record) database and Diasend software, where information from the FGS device is downloaded. We recorded HbA1c levels before using the Freestyle Libre device, whether the patient continued to use the monitor for approximately 3 months and the HbA1c level 3 months after.
Results: One hundred and twenty-one patients were identified with T1DM who had used the FGS device. 63 patients stopped using the device in less than 3 months. Patient data was unavailable for 2 patients. The 56 patients who continued to use the device for 3 months included 30 males and 26 females with an average age of 13 years and 6 months when using the device. Duration of diabetes was approximately 8 years and 5 months. Results suggested an average reduction in HbA1c from 63.66 mmol/mol (SD±16.3) to 60.41 mmol/mol (SD±15.72), a difference of 3.25 mmol/mol (P<0.05). CI =0.1 to 6.4. Patients who discontinued using the FGS device had an average increase in HBA1C of 2.48 mmol/mol (P<0.05), from 57.74 mmol/mol (SD±9.73) to 59.95 mmol/mol (SD±10.93). CI =−4.02 to −0.43. Reasons for discontinuation of the FGS device included reduced accuracy and financial costs.
Conclusion: The change in HbA1c levels 3 months after using the FGS device suggests it is useful in helping monitor and reduce the average HbA1c level in children and young people. Future work assessing quality of life and level of hypoglycaemia reduction may further inform its use.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology