Posters. Absteacts
FreeStyle Libre™ Use for Self-Management of Diabetes in Teenagers and Young Adults
Author FIONA  CAMPBELL, JAN BOLINDER, Leeds, United Kingdom, Stockholm, Sweden

The challenges of caring for diabetes in teenagers and young adults are well known. We analyzed two research studies (IMPACT and SELFY) that evaluated FreeStyle LibreTM Flash Glucose Monitoring System as a replacement for self-monitoring of blood glucose (SMBG), looking specifically at outcomes in patients aged 13-24 years. IMPACT enrolled 241 patients with well controlled type 1 diabetes (T1DM), HbA1c 6.74±0.56% (50.1±6.1 mmol/mol), age 43.7±13.9 years (mean±SD) into a 6 month European RCT (23 sites). The control group (n=121) used SMBG and the intervention group used FreeStyle Libre for self-management.
Of the 241 patients, 19 were aged 18-24 years. SELFY enrolled 76 young people aged 10.3±4.0 years (mean±SD), baseline HbA1c 7.9±1.0% (62.9±11.1 mmol/mol) into a 10 week single arm European study (10 sites).
The study consisted of 2 weeks baseline masked (blinded) wear, followed by 8 weeks open use. Of the 76 patients, 25 were aged 13-17 years.
IMPACT study results at 6 months showed no significant interaction of age with treatment group for the primary endpoint of time in hypoglycemia <70 mg/dL.
For the younger adults, time in range (TIR) (70-180 mg/dL) significantly increased by 2.9±0.89 hours/day (mean±SE); p=0.0055. Time in hyperglycemia (>180 mg/dL) also significantly improved with a reduction of 2.40±0.834 hours/day (mean±SE); p=0.0113. Intervention group patients scanned the sensor on average 11.3 times daily.
Teenagers in the SELFY study significantly improved the primary endpoint of TIR (70-180 mg/dL) by 1.2±2.5 hours/day (mean±SD), p=0.0254. HbA1c also significantly improved, -0.7±0.6%, p<0.0001. Time in hyperglycemia (>180 mg/dL) significantly reduced by -1.7±2.9 hours/day, p=0.0093, no statistically significant changes were observed in hypoglycemia (time<55 mg/dL, baseline 0.7±1.0 hours/day). Scan frequency of FreeStyle Libre was on average 9.7 times daily.
The IMPACT and SELFY studies both demonstrated improvements in glycemic control in the teenager and young adult age groups.
Beneficial Effect of Flash Glucose Monitoring Persists in a Two-Year Perspective—A Clinical Follow-Up Study of 334 Individuals with Type 1 Diabetes

Short term follow-up studies indicate that use of Flash glucose monitoring (FGM) improves metabolic control in people with type 1 diabetes. Whether this effect persists is unknown.
The aim of this study was to evaluate long-term effects on HbA1c and treatment satisfaction in propre with type 1 diabetes after introduction of FGM in a university hospital diabetes clinic. Treatment satisfaction was measured using DTSQs questionnaires at the one year follow-up.
Of the first 334 patients who were introduced to FGM 80.5% were still users after 2 years, 8.7% changed to a CGM-system, 6.6% stopped due to skin reactions, 3.4% did not want to continue and 1.3% had died. Baseline HbA1c among continuers were 71.8±16.6 mmol/mol (8.7%). Compared to baseline,
HbA1c was -8.3±9.8 mmol/mol after 1 year and 9.0±11.8 mmol/mol lower after 2 years. Self-estimated treatment satisfaction after 1 year was 2.44±0.74 (+3 to -3) and rating for continued FGM use was 2.87±0.33.
Unacceptable high blood glucose was less often present (-0.6) as were unacceptable low blood glucose levels (-0.3).

Conclusions: Use of FGM adds clinical significant advantage to individuals with 1 diabetes in terms of HbA1c reduction and improved self-estimated treatment satisfaction also in a 2-year perspective.
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