Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit

Research output: Contribution to journalArticlepeer-review

Standard

Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit. / Deshmukh, Harshal; Wilmot, Emma G; Gregory, Robert; Barnes, Dennis; Narendran, Parth; Saunders, Simon; Furlong, Niall; Kamaruddin, Shafie; Banatwalla, Rumaisa; Herring, Roselle; Kilvert, Anne; Patmore, Jane; Walton, Chris; Ryder, Robert E J; Sathyapalan, Thozhukat.

In: Diabetes Care, Vol. 43, No. 9, 09.2020, p. 2153-2160.

Research output: Contribution to journalArticlepeer-review

Harvard

Deshmukh, H, Wilmot, EG, Gregory, R, Barnes, D, Narendran, P, Saunders, S, Furlong, N, Kamaruddin, S, Banatwalla, R, Herring, R, Kilvert, A, Patmore, J, Walton, C, Ryder, REJ & Sathyapalan, T 2020, 'Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit', Diabetes Care, vol. 43, no. 9, pp. 2153-2160. https://doi.org/10.2337/dc20-0738

APA

Deshmukh, H., Wilmot, E. G., Gregory, R., Barnes, D., Narendran, P., Saunders, S., Furlong, N., Kamaruddin, S., Banatwalla, R., Herring, R., Kilvert, A., Patmore, J., Walton, C., Ryder, R. E. J., & Sathyapalan, T. (2020). Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit. Diabetes Care, 43(9), 2153-2160. https://doi.org/10.2337/dc20-0738

Vancouver

Author

Deshmukh, Harshal ; Wilmot, Emma G ; Gregory, Robert ; Barnes, Dennis ; Narendran, Parth ; Saunders, Simon ; Furlong, Niall ; Kamaruddin, Shafie ; Banatwalla, Rumaisa ; Herring, Roselle ; Kilvert, Anne ; Patmore, Jane ; Walton, Chris ; Ryder, Robert E J ; Sathyapalan, Thozhukat. / Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit. In: Diabetes Care. 2020 ; Vol. 43, No. 9. pp. 2153-2160.

Bibtex

@article{9131e74498424c348aedcfe4e7f27e29,
title = "Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit",
abstract = "OBJECTIVE: The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions.RESEARCH DESIGN AND METHODS: Clinicians from 102 NHS hospitals in the U.K. submitted FSL user data, collected during routine clinical care, to a secure web-based tool held within the NHS N3 network. The t and Mann-Whitney U tests were used to compare the baseline and follow-up HbA1c and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA1c following the use of FSL. Within-person variations of HbA1c were calculated using HbA1c=SD/√(n/[n-1].RESULTS: Data were available for 10,370 FSL users (97% with type 1 diabetes), age 38.0 (±18.8) years, 51% female, diabetes duration 16.0 (±49.9) years, and BMI of 25.2 (±16.5) kg/m2 (mean [±SD]). FSL users demonstrated a −5.2 mmol/mol change in HbA1c, reducing from 67.5 (±20.9) mmol/mol (8.3%) at baseline to 62.3 (±18.5) mmol/mol (7.8%) after 7.5 (interquartile range 3.4–7.8) months of follow-up (n = 3,182) (P < 0.0001). HbA1c reduction was greater in those with initial HbA1c ≥69.5 mmol/mol (>8.5%), reducing from 85.5 (±16.1) mmol/mol (10%) to 73.1 (±15.8) mmol/mol (8.8%) (P < 0.0001). The baseline Gold score (score for hypoglycemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) (P < 0.0001) at follow-up. A total of 53% of those with a Gold score of ≥4 at baseline had a score <4 at follow-up. FSL use was also associated with a reduction in diabetes distress (P < 0.0001). FSL use was associated with a significant reduction in paramedic callouts and hospital admissions due to hypoglycemia and hyperglycemia/diabetic ketoacidosis.CONCLUSIONS: We show that the use of FSL was associated with significantly improved glycemic control and hypoglycemia awareness and a reduction in hospital admissions.",
author = "Harshal Deshmukh and Wilmot, {Emma G} and Robert Gregory and Dennis Barnes and Parth Narendran and Simon Saunders and Niall Furlong and Shafie Kamaruddin and Rumaisa Banatwalla and Roselle Herring and Anne Kilvert and Jane Patmore and Chris Walton and Ryder, {Robert E J} and Thozhukat Sathyapalan",
note = "{\textcopyright} 2020 by the American Diabetes Association.",
year = "2020",
month = sep,
doi = "10.2337/dc20-0738",
language = "English",
volume = "43",
pages = "2153--2160",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association",
number = "9",

}

RIS

TY - JOUR

T1 - Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit

AU - Deshmukh, Harshal

AU - Wilmot, Emma G

AU - Gregory, Robert

AU - Barnes, Dennis

AU - Narendran, Parth

AU - Saunders, Simon

AU - Furlong, Niall

AU - Kamaruddin, Shafie

AU - Banatwalla, Rumaisa

AU - Herring, Roselle

AU - Kilvert, Anne

AU - Patmore, Jane

AU - Walton, Chris

AU - Ryder, Robert E J

AU - Sathyapalan, Thozhukat

N1 - © 2020 by the American Diabetes Association.

PY - 2020/9

Y1 - 2020/9

N2 - OBJECTIVE: The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions.RESEARCH DESIGN AND METHODS: Clinicians from 102 NHS hospitals in the U.K. submitted FSL user data, collected during routine clinical care, to a secure web-based tool held within the NHS N3 network. The t and Mann-Whitney U tests were used to compare the baseline and follow-up HbA1c and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA1c following the use of FSL. Within-person variations of HbA1c were calculated using HbA1c=SD/√(n/[n-1].RESULTS: Data were available for 10,370 FSL users (97% with type 1 diabetes), age 38.0 (±18.8) years, 51% female, diabetes duration 16.0 (±49.9) years, and BMI of 25.2 (±16.5) kg/m2 (mean [±SD]). FSL users demonstrated a −5.2 mmol/mol change in HbA1c, reducing from 67.5 (±20.9) mmol/mol (8.3%) at baseline to 62.3 (±18.5) mmol/mol (7.8%) after 7.5 (interquartile range 3.4–7.8) months of follow-up (n = 3,182) (P < 0.0001). HbA1c reduction was greater in those with initial HbA1c ≥69.5 mmol/mol (>8.5%), reducing from 85.5 (±16.1) mmol/mol (10%) to 73.1 (±15.8) mmol/mol (8.8%) (P < 0.0001). The baseline Gold score (score for hypoglycemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) (P < 0.0001) at follow-up. A total of 53% of those with a Gold score of ≥4 at baseline had a score <4 at follow-up. FSL use was also associated with a reduction in diabetes distress (P < 0.0001). FSL use was associated with a significant reduction in paramedic callouts and hospital admissions due to hypoglycemia and hyperglycemia/diabetic ketoacidosis.CONCLUSIONS: We show that the use of FSL was associated with significantly improved glycemic control and hypoglycemia awareness and a reduction in hospital admissions.

AB - OBJECTIVE: The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions.RESEARCH DESIGN AND METHODS: Clinicians from 102 NHS hospitals in the U.K. submitted FSL user data, collected during routine clinical care, to a secure web-based tool held within the NHS N3 network. The t and Mann-Whitney U tests were used to compare the baseline and follow-up HbA1c and other baseline demographic characteristics. Linear regression analysis was used to identify predictors of change in HbA1c following the use of FSL. Within-person variations of HbA1c were calculated using HbA1c=SD/√(n/[n-1].RESULTS: Data were available for 10,370 FSL users (97% with type 1 diabetes), age 38.0 (±18.8) years, 51% female, diabetes duration 16.0 (±49.9) years, and BMI of 25.2 (±16.5) kg/m2 (mean [±SD]). FSL users demonstrated a −5.2 mmol/mol change in HbA1c, reducing from 67.5 (±20.9) mmol/mol (8.3%) at baseline to 62.3 (±18.5) mmol/mol (7.8%) after 7.5 (interquartile range 3.4–7.8) months of follow-up (n = 3,182) (P < 0.0001). HbA1c reduction was greater in those with initial HbA1c ≥69.5 mmol/mol (>8.5%), reducing from 85.5 (±16.1) mmol/mol (10%) to 73.1 (±15.8) mmol/mol (8.8%) (P < 0.0001). The baseline Gold score (score for hypoglycemic unawareness) was 2.7 (±1.8) and reduced to 2.4 (±1.7) (P < 0.0001) at follow-up. A total of 53% of those with a Gold score of ≥4 at baseline had a score <4 at follow-up. FSL use was also associated with a reduction in diabetes distress (P < 0.0001). FSL use was associated with a significant reduction in paramedic callouts and hospital admissions due to hypoglycemia and hyperglycemia/diabetic ketoacidosis.CONCLUSIONS: We show that the use of FSL was associated with significantly improved glycemic control and hypoglycemia awareness and a reduction in hospital admissions.

U2 - 10.2337/dc20-0738

DO - 10.2337/dc20-0738

M3 - Article

C2 - 32669277

VL - 43

SP - 2153

EP - 2160

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 9

ER -