Differences of FreeStyle Libre Flash Glucose Monitoring System and Finger Pricks on Clinical Characteristics and Glucose Monitoring Satisfactions in Type 1 Diabetes Using Insulin Pump

Clin Med Insights Endocrinol Diabetes. 2019 Jul 1:12:1179551419861102. doi: 10.1177/1179551419861102. eCollection 2019.

Abstract

Background: To evaluate the different experience of freestyle libre and finger pricks on clinical characteristics and glucose monitoring satisfaction (GMS) in patients with type 1 diabetes (T1D) using insulin pump (IP).

Methods: A prospective study was carried out on 47 (aged 17-21 years) T1D, who used conventional finger-pricking method for self-testing the glucose. The experiments were conducted between March 2018 and September 2018. For carrying out the study, the flash glucose monitoring (FGM) sensors were placed on each participant, at the baseline visit, by a trained diabetes educator. Furthermore, to determine the total number of scans conducted during the study period, the respective ambulatory glucose profiles were generated by computing the data collected from the sensors. In addition, a trained interviewer handed over the GMS questionnaire to each patient, at the baseline and at 12 weeks of the study.

Results: In comparison to the baseline (finger pricks), various parameters such as: HbA1c (P = .042), hypoglycemia (P = .001), mean capillary glucose (P = .004), total daily insulin dose (P = .0001), percentage of bolus insulin (P = .0001), daily bolus frequency (P = .0001), and daily carbohydrates intake (P = .0001) showed a significant improvement at 12 weeks. Similarly, substantial augmentation was noticed, in the sub domains of GMS, that is, openness (P = .0001), emotional burden (P = .0001), behavioral burden (P = .0001), and trust (P = .0001) at 12 weeks as compared to baseline. Overall, total GMS score at baseline was 1.72 ± 0.37, which increased up to 3.41 ± 0.49 (P = .0001) in the time period of 12 weeks. The HbA1c (r2 = 0.45), hypoglycemia (r2 = 0.58), and the mean number of FGM scans, exhibited a negative correlation, while GMS (r2 = 0.52) and the mean number of FGM scans, exhibited a positive correlation.

Conclusion: The frequency of hypoglycemia, HbA1c level, capillary glucose, daily carbohydrates intake decreased, while the total daily insulin dose, daily bolus insulin and total GMS score increased with the use of FGM scanning for 12 weeks.

Keywords: Type 1 diabetes; finger pricks; freestyle libre; glycemic control; hypoglycemia; satisfaction; self-testing.