69-OR: Freestyle Libre System Use Is Associated with Reduction in Inpatient and Outpatient Emergency Acute Diabetes Events and All-Cause Hospitalizations in Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 69-OR
Author(s):  
RICHARD M. BERGENSTAL ◽  
MATTHEW S.D. KERR ◽  
GREGORY J. ROBERTS ◽  
DIANA SOUTO ◽  
YELENA NABUTOVSKY ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Freestyle Libre ◽  
System Use ◽  
Acute Diabetes

85-LB: Freestyle Libre System Use Associated with Reduction in Acute Diabetes Events and All-Cause Hospitalizations in Patients with Type 2 Diabetes without Bolus Insulin

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 85-LB ◽  
Author(s):  
EDEN MILLER ◽  
MATTHEW S.D. KERR ◽  
GREGORY J. ROBERTS ◽  
DIANA SOUTO ◽  
YELENA NABUTOVSKY ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Freestyle Libre ◽  
System Use ◽  
Acute Diabetes ◽  
Bolus Insulin

68-LB: Acute Diabetes Events and All-Cause Hospitalizations among Continuous Glucose Monitoring Device Recipients with Type 1 and Type 2 Diabetes: A Comparison of FreeStyle Libre and Dexcom

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 68-LB
Author(s):  
IRL B. HIRSCH ◽  
GREGORY J. ROBERTS ◽  
JENNIFER JOSEPH ◽  
YELENA NABUTOVSKY ◽  
NAUNIHAL VIRDI ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Monitoring Device ◽  
Freestyle Libre ◽  
Acute Diabetes

scholarly journals Important Drop Rate of Acute Diabetes Complications in People With Type 1 or Type 2 Diabetes After Initiation of Flash Glucose Monitoring in France: The RELIEF Study

2021 ◽  
Author(s):  
Ronan Roussel ◽  
Jean-Pierre Riveline ◽  
Eric Vicaut ◽  
Gérard de Pouvourville ◽  
Bruno Detournay ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Diabetes Complications ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Freestyle Libre ◽  
Before And After ◽  
Acute Diabetes

<b>Objective</b> <p>The RELIEF study assessed rates of hospitalization for acute diabetes complications in France, before and after initiating the FreeStyle Libre system. </p> <p><b>Research Design and Methods</b></p> <p>74,011 patients with type 1 diabetes or type 2 diabetes who initiated the FreeStyle Libre system were identified from the French national claim database (SNDS) using ICD-10 codes, from hospitalizations with diabetes as a contributing diagnosis, or the prescription of insulin. Patients were sub-classified based on SMBG strip-acquisition prior to starting FreeStyle Libre. Hospitalizations for DKA, severe hypoglycemia, diabetes-related coma and hyperglycemia were recorded for the 12 months before and after initiation. </p> <p><b>Results</b></p> <p>Hospitalizations for acute diabetes complications fell in type 1 diabetes (-49.0%) and in type 2 diabetes (-39.4%) following FreeStyle Libre initiation. DKA fell in type 1 diabetes (-56.2%,) and in type 2 diabetes (-52.1%), as did diabetes-related comas in type 1 diabetes (-39.6%) and in type 2 diabetes (-31.9%). Hospitalizations for hypoglycemia and hyperglycemia decreased in type 2 diabetes (-10.8% and -26.5%, respectively). Before initiation, hospitalizations were most marked for people non-compliant with SMBG and for those with highest acquisition of SMBG, which fell by -54.0% and 51.2% respectively following FreeStyle Libre initiation. Persistence with FreeStyle Libre at 12 months was 98.1%.</p> <p><b>Conclusions</b></p> <p>This large retrospective study on hospitalizations for acute diabetes complication shows that a significantly lower incidence of admissions for DKA and for diabetes-related coma is associated with use of flash glucose monitoring. This study has significant implications for patient-centered diabetes care and potentially for long-term health economic outcomes.</p> <br> <p> </p>

scholarly journals Important Drop Rate of Acute Diabetes Complications in People With Type 1 or Type 2 Diabetes After Initiation of Flash Glucose Monitoring in France: The RELIEF Study

2021 ◽  
Author(s):  
Ronan Roussel ◽  
Jean-Pierre Riveline ◽  
Eric Vicaut ◽  
Gérard de Pouvourville ◽  
Bruno Detournay ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Diabetes Complications ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Freestyle Libre ◽  
Before And After ◽  
Acute Diabetes

<b>Objective</b> <p>The RELIEF study assessed rates of hospitalization for acute diabetes complications in France, before and after initiating the FreeStyle Libre system. </p> <p><b>Research Design and Methods</b></p> <p>74,011 patients with type 1 diabetes or type 2 diabetes who initiated the FreeStyle Libre system were identified from the French national claim database (SNDS) using ICD-10 codes, from hospitalizations with diabetes as a contributing diagnosis, or the prescription of insulin. Patients were sub-classified based on SMBG strip-acquisition prior to starting FreeStyle Libre. Hospitalizations for DKA, severe hypoglycemia, diabetes-related coma and hyperglycemia were recorded for the 12 months before and after initiation. </p> <p><b>Results</b></p> <p>Hospitalizations for acute diabetes complications fell in type 1 diabetes (-49.0%) and in type 2 diabetes (-39.4%) following FreeStyle Libre initiation. DKA fell in type 1 diabetes (-56.2%,) and in type 2 diabetes (-52.1%), as did diabetes-related comas in type 1 diabetes (-39.6%) and in type 2 diabetes (-31.9%). Hospitalizations for hypoglycemia and hyperglycemia decreased in type 2 diabetes (-10.8% and -26.5%, respectively). Before initiation, hospitalizations were most marked for people non-compliant with SMBG and for those with highest acquisition of SMBG, which fell by -54.0% and 51.2% respectively following FreeStyle Libre initiation. Persistence with FreeStyle Libre at 12 months was 98.1%.</p> <p><b>Conclusions</b></p> <p>This large retrospective study on hospitalizations for acute diabetes complication shows that a significantly lower incidence of admissions for DKA and for diabetes-related coma is associated with use of flash glucose monitoring. This study has significant implications for patient-centered diabetes care and potentially for long-term health economic outcomes.</p> <br> <p> </p>

scholarly journals A review of flash glucose monitoring in type 2 diabetes

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Marcio Krakauer ◽  
Jose Fernando Botero ◽  
Fernando J. Lavalle-González ◽  
Adrian Proietti ◽  
Douglas Eugenio Barbieri
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Real World ◽  
Glucose Monitoring ◽  
Well Being ◽  
Main Body ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
Freestyle Libre

Abstract Background Continuous glucose monitoring systems are increasingly being adopted as an alternative to self-monitoring of blood glucose (SMBG) by persons with diabetes mellitus receiving insulin therapy. Main body The FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, United Kingdom) consists of a factory-calibrated sensor worn on the back of the arm which measures glucose levels in the interstitial fluid every minute and stores the reading automatically every 15 min. Swiping the reader device over the sensor retrieves stored data and displays current interstitial glucose levels, a glucose trend arrow, and a graph of glucose readings over the preceding 8 h. In patients with type 2 diabetes (T2D) receiving insulin therapy, pivotal efficacy data were provided by the 6-month REPLACE randomized controlled trial (RCT) and 6-month extension study. Compared to SMBG, the flash system significantly reduced the time spent in hypoglycemia and frequency of hypoglycemic events, although no significant change was observed in glycosylated hemoglobin (HbA1c) levels. Subsequent RCTs and real-world chart review studies have since shown that flash glucose monitoring significantly reduces HbA1c from baseline. Real-world studies in both type 1 diabetes or T2D populations also showed that flash glucose monitoring improved glycemic control. Higher (versus lower) scanning frequency was associated with significantly greater reductions in HbA1c and significant improvements in other measures such as time spent in hypoglycemia, time spent in hyperglycemia, and time in range. Additional benefits associated with flash glucose monitoring versus SMBG include reductions in acute diabetes events, all-cause hospitalizations and hospitalized ketoacidosis episodes; improved well-being and decreased disease burden; and greater treatment satisfaction. Conclusion T2D patients who use flash glucose monitoring might expect to achieve significant improvement in HbA1c and glycemic parameters and several associated benefits.

scholarly journals Impact of free-living pattern of sedentary behaviour on intra-day glucose regulation in type 2 diabetes

2019 ◽  
Vol 120 (1) ◽  
pp. 171-179 ◽  
Author(s):  
Aye C. Paing ◽  
Kathryn A. McMillan ◽  
Alison F. Kirk ◽  
Andrew Collier ◽  
Allan Hewitt ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sedentary Behaviour ◽  
Sedentary Time ◽  
Glucose Monitoring ◽  
Glucose Regulation ◽  
Dawn Phenomenon ◽  
Freestyle Libre ◽  
Breaks In Sedentary Time ◽  
Target Glucose

Abstract Purpose To investigate how the pattern of sedentary behaviour affects intra-day glucose regulation in type 2 diabetes. Methods This intensive longitudinal study was conducted in 37 participants with type 2 diabetes (age, 62.8 ± 10.5 years). Glucose and sedentary behaviour/physical activity were assessed with a continuous glucose monitoring (Abbott FreeStyle Libre) and an activity monitor (activPAL3) for 14 days. Multiple regression models with generalised estimating equations (GEEs) approach were used to assess the associations of sedentary time and breaks in sedentary time with pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, post-lunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, time in target glucose range (TIR, glucose 3.9–10 mmol/L) and time above target glucose range (TAR, glucose > 10 mmol/L). Results Sedentary time was associated with higher pre-breakfast glucose (p = 0.001), pre-dinner glucose (p < 0.001), post-lunch glucose (p = 0.005), post-dinner glucose (p = 0.013) and the dawn phenomenon (p < 0.001). Breaks in sedentary time were associated with lower pre-breakfast glucose (p = 0.023), pre-dinner glucose (p = 0.023), post-breakfast glucose (p < 0.001) and the dawn phenomenon (p = 0.004). The association between sedentary time and less TIR (p = 0.022) and the association between breaks in sedentary time and more TIR (p = 0.001) were also observed. Conclusions Reducing sedentary time and promoting breaks in sedentary time could be clinically relevant to improve intra-day glucose regulation in type 2 diabetes.

scholarly journals Association Between Time in Range and HbA1c in Japanese Patients With Type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Akira Kurozumi ◽  
Yosuke Okada ◽  
Tomoya Mita ◽  
Satomi Wakasugi ◽  
Naoto Katakami ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Large Scale ◽  
High Body Mass Index ◽  
Japanese Patients ◽  
Freestyle Libre ◽  
Time In Range

Abstract There are no large-scale studies on the association between time in range (TIR) and hemoglobin A1c (HbA1c) in Japanese patients with type 2 diabetes mellitus (T2DM) only. The aim of this study was to define the relationship between TIR and HbA1c levels in Japanese patients with T2DM. The glycemic profile of 999 patients was analyzed with FreeStyle Libre Pro Continuous Glucose Monitoring (FLP-CGM) while they continued their prescribed glucose-lowering medications. FLP-CGM data recorded over 8 consecutive days were analyzed. The regression model for HbA1c on TIR was HbA1c = 9.4966 − 0.0309×TIR. The predicted HbA1c level for TIR of 70% was 7.33%, and is higher than recent reports subjecting mostly T1DM. The TIR corresponding to HbA1c 7.0% was 80.64%. HbA1c level correlated significantly with many FLP-CGM-derived metrics. The patients with low TIR tended to have long history of diabetes, on higher daily insulin dose and had high body mass index, HbA1c, liver dysfunction and triglyceride. Furthermore, relatively higher percentages of patients of this group used sulfonylureas, glinides, glucagon like peptide-1 receptor agonists and insulin. Our data showed that the predicted HbA1c corresponding to TIR is largely depends on the study population, thus is not uniform. Our results provide new insights on the management of T2DM.

The Impact of Dual Health Care System Use for Obtaining Prescription Medications on Nonadherence in Veterans With Type 2 Diabetes

2019 ◽  
Vol 53 (7) ◽  
pp. 675-682 ◽  
Author(s):  
David J. Taber ◽  
Ralph Ward ◽  
R. Neal Axon ◽  
Rebekah J. Walker ◽  
Leonard E. Egede ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care System ◽  
Prescription Medications ◽  
System Use ◽  
The Impact ◽  
Care System

scholarly journals Integration of Flash Glucose Monitoring During the Transition of Care From Inpatient to Outpatient Settings in Patients With Type 2 Diabetes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A427-A428
Author(s):  
Radhika Jaiswal ◽  
Meng Zhang ◽  
Sharon Zuniga ◽  
Alyson K Myers
Keyword(s):  
Type 2 Diabetes ◽  
Hospital Discharge ◽  
Mobile Application ◽  
Glucose Monitoring ◽  
Outpatient Setting ◽  
Transition Of Care ◽  
Freestyle Libre ◽  
The Mean ◽  
Outpatient Settings

Abstract Background: The use of continuous glucose monitoring (CGM) technology in the outpatient setting has been associated with both improved patient satisfaction1 and increased glucose monitoring2. It remains to be seen, how well this technology can be integrated during the transition from hospital discharge to outpatient settings. Here, we aim to assess the feasibility of introducing the FreeStyle Libre during the transition of care from inpatient to the outpatient environment in patients with Type 2 diabetes (T2D). We will assess CGM use as measured by the numbers of days used and frequency of daily scans. Methods: During the time period April and September 2020, 20 patients with T2D being discharged on multiple daily injections admitted to North Shore University Hospital were enrolled in this study. Exclusion criteria were those with adhesive allergy, CKD 4/5 or on dialysis and pregnant women. Participants were trained on how to use the FreeStyle Libre with the LibreLink mobile application. All patients received 2 Libre sensors at the time of discharge, one that was placed in the hospital and the other to be placed after 14 days. 1 participant died prior to discharge. Analyses included descriptive statistics, specifically categorical variables using frequencies and percentages while continuous variables using mean and standard deviation. Results: Among who used the mobile application, 10 were men and 9 were women. Majority of patients were Black (n=11, 57.9%) with a mean age of 52 years (range 31–76). The mean duration of diabetes was 9.7 years (range: 0 to 22) and mean Hemoglobin A1c of 11.2% (range: 5.5–15.5). 10 out of 19 persons used CGM for more than 2 weeks, while the remaining 9 utilized the CGM for less than 2 weeks. Mean average daily scans were 5 times per day (range: 1–12) with majority of the persons (n=15, 78.9%) scanning more frequently (3 or more times per day). The average glucose ranged from 62 to 268 mg/dl and the mean active CGM time was 52.05% (range 0–98). Mean glycemic variability was 29.17% (range: 14.5–56.7). Technical issues with the CGM included poor adhesion or issues connecting to the mobile application. Conclusion: Our study found that the initiation of CGM during the transition from hospital discharge to the outpatient setting is feasible and a useful tool. A limitation of this study was the inability for all people to use the mobile application due to incompatible phones or operating systems. References: 1. Beck RW, Riddlesworth TD, Ruedy K, et al. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. Ann Intern Med. 2017;167(6):365–374. doi:10.7326/M16-2855. 2. Shehav-Zaltzman G, Segal G, Konvalina N, Tirosh A. Remote Glucose Monitoring of Hospitalized, Quarantined Patients With Diabetes and COVID-19. Diabetes Care. 2020;43(7):e75-e76. doi:10.2337/dc20-0696.

Sign in / Sign up

Export Citation Format

Share Document