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

Devices and Technology – September 2020 digest

Three late-breaking abstracts presented at the 2020 ADA Scientific Sessions demonstrate the beneficial effects of FreeStyle Libre use on glycaemic control and hospitalisations in people with type 2 diabetes.

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 HbA1c 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, HbA1c 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 HbA1c 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 (HbA1c ≥64 mmol/mol [8.0%] at baseline) at 6 months after Libre initiation. Overall, mean HbA1c fell from 88 mmol/mol (10.2%) at baseline to 73 mmol/mol (8.8%) at 6 months. Those with the highest HbA1c 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) HbA1c reduction after initiation of the FreeStyle Libre system in type 2 diabetes patients on long-acting insulin or noninsulin therapy. American Diabetes Association 80th Scientific Sessions: Abstract 84-LB

2. Wright E, Kerr MSD, Reyes IJ et al (2020) HbA1c reduction associated with a FreeStyle Libre system in people with type 2 diabetes not on bolus insulin therapy. American Diabetes Association 80th 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 80th Scientific Sessions: Abstract 85-LB

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