Flash glucose monitoring reduces rate of acute diabetes events 2 years after initiation
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The use of flash glucose monitoring is associated with a reduction in hospitalization for acute diabetes events, particularly diabetic ketoacidosis, for people with type 1 and type 2 diabetes, according to study data.
As Healio previously reported, in the RELIEF study, researchers found people with diabetes had a lower rate of acute diabetes events 12 months after starting flash glucose monitoring compared with before initiation. In a follow-up study published in Diabetes Technology & Therapeutics, the benefits of flash glucose monitoring for reducing acute diabetes hospitalizations extended to 24 months after initiation.
“The initial 12-month outcomes showed a considerable reduction in hospital admissions for acute diabetes events for people using the FreeStyle Libre (Abbott) system compared with the 12-month period before reimbursement,” Jean-Pierre Riveline, MD, PhD, professor at University Center for Diabetology and its Complications at Lariboisière Hospital in Paris, France, and colleagues wrote. “Although not identical, the most recent [Système National des Données de Santé (SNDS)] data set covering the full 24-month reimbursement period since late 2017 shows comparable reductions in the rate of acute diabetes events in the year after starting the FreeStyle Libre system, with a 42% reduction in the overall rate of acute diabetes events requiring hospitalizations in type 1 diabetes and a 49% fall in the rate of admissions for DKA. These reductions were mirrored in type 2 diabetes.”
RELIEF was a longitudinal retrospective cohort study using data from the SNDS French claims database. People with type 1 or type 2 diabetes who began using the FreeStyle Libre system from Aug. 1, 2017, to Dec. 31, 2017, were included. Data were collected through Dec. 31, 2019. Acute diabetes events included hospitalization for DKA, severe hypoglycemia, diabetes-related coma and hyperglycemia-related hospitalization. Participants were considered to have discontinued using their device when no sensors were delivered to a participant over consecutive 6-month periods.
The study included 31,446 people with type 1 diabetes and 41,027 with type 2 diabetes. The type 1 diabetes group was younger (mean age, 37.5 years vs. 59.2 years) and had a higher percentage of male participants (52.3% vs. 56.5%).
Compared with the 12 months before starting flash glucose monitoring, there was a reduction in the percentage of participants hospitalized with an acute diabetes event 24 months after initiation. The type 1 diabetes group had a 49% reduction in hospitalizations at 2 years, and the type 2 diabetes group had a 48% reduction. Both reductions were mainly due to a 53% decrease in DKA admission in the type 1 diabetes group and a 47% reduction in DKA hospitalization for people with type 2 diabetes. The decreases were consistent with what was observed at 12 months in the initial RELIEF study.
At 1 year, 89% of the study population was still using the device. That persistence rate was similar at 88% at 2 years. Most device discontinuation was observed within 6 years of initiation.
Prior to starting flash glucose monitoring, the median number of daily self-monitoring blood glucose tests administered was 3.8 in the type 1 diabetes group and 3.2 in those with type 2 diabetes. At 1 year, 44.1% of the type 1 diabetes group and 46.9% of the type 2 diabetes group were not acquiring new self-monitoring test strips. At 2 years, the percentage of those not using test strips increased to 68.2% of people with type 1 diabetes and 74.6% of people with type 2 diabetes.
“Overall, this analysis reinforces the significant implications for patient-centered clinical care of using the FreeStyle Libre system in diabetes and supports the continued investigation of the long-term health economic benefits at a national level,” the researchers wrote.
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