Sponsored: Use of FreeStyle Libre in people with type 2 diabetes reduces HbA1c and hospitalisations

Sponsored selections: Three late-breaking abstracts presented at the 2020 American Diabetes Association Scientific Sessions demonstrate the beneficial effects of FreeStyle Libre use on glycaemic control and hospitalisations in people with type 2 diabetes. All three were retrospective, observational studies. People on intensive insulin regimens (requiring bolus dosing) were excluded from the analyses.

In the first study¹, people with a baseline HbA_1c of 48 mmol/mol (6.5%) or over were followed up at 6 and 12 months after Libre initiation. From a mean of 69 mmol/mol (8.5%) at baseline, HbA_1c fell to 61 mmol/mol (7.7%) at 6 months (n=774) and 63 mmol/mol (7.9%) at 12 months (n=207). Participants had HbA_1c reductions regardless of whether they were on basal insulin or non-insulin therapies.

In the second study², the authors reviewed 1183 individuals with poor glycaemic control (HbA_1c ≥64 mmol/mol [8.0%] at baseline) at 6 months after Libre initiation. Overall, mean HbA_1c fell from 88 mmol/mol (10.2%) at baseline to 73 mmol/mol (8.8%) at 6 months. Those with the highest HbA_1c at baseline (≥108 mmol/mol [12.0%]) had the greatest reduction, of 39 mmol/mol (3.55%) on average.

Those on non-insulin therapies had greater reductions than those on insulin (mean reduction, 17 vs 11 mmol/mol [1.56% vs 0.99%]. For those not using insulin, these results imply that using the Libre could have a similar impact to initiating insulin therapy, suggesting that people could use the FreeStyle Libre system to manage their glucose levels instead of adding insulin.

The final study³ compared the rate of diabetes emergencies in the 6 months before and after Libre initiation in 7167 individuals. The rate of acute diabetes events (hospitalisation or outpatient emergency as a result of hypo- or hyperglycaemia) fell from 0.071 to 0.052 events per person-year (hazard ratio, 0.70; 95% CI, 0.57–0.85). All-cause hospitalisation rates fell from 0.180 to 0.161 events per person-year (hazard ratio, 0.87; 95% CI, 0.78–0.98).

1. Miller E, Brandner L, Wright E (2020) HbA_1c reduction after initiation of the FreeStyle Libre system in type 2 diabetes patients on long-acting insulin or noninsulin therapy. American Diabetes Association 80^th Scientific Sessions: Abstract 84-LB

2. Wright E, Kerr MSD, Reyes IJ et al (2020) HbA_1c reduction associated with a FreeStyle Libre system in people with type 2 diabetes not on bolus insulin therapy. American Diabetes Association 80^th Scientific Sessions: Abstract 78-LB

3. Miller E, Kerr MSD, Roberts GJ et al (2020) FreeStyle Libre system use associated with reduction in acute diabetes events and all-cause hospitalizations in patients with type 2 diabetes without bolus insulin. American Diabetes Association 80^th Scientific Sessions: Abstract 85-LB

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