Glucose Awareness to Motivate and Enable Solutions (GAMES) in diabetes mellitus using flash glucose monitoring: A clinical programme. Issue 1 (30th October 2021)

• Record Type: Journal Article
• Authors: Yeoh, Ester; Png, Doanna; Koh, Pei Ling; Sum, Chee Fang; Lim, Su Chi; Tan, Hwee Huan; Ubeynarayana, Chalani Udhyami; Subramaniam, Tavintharan
• Is Part Of: Diabetic medicine. Volume 39:Issue 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-10-30
• Subjects: blood glucose monitoring -- diabetes mellitus -- flash glucose monitoring -- glucose sensors -- glycaemic variability; Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14733
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: This real‐world observational clinical programme evaluated short and medium‐term effects of intermittent flash glucose monitoring on HbA1c, glycaemic variability and lifestyle behavioural changes. Methods: Two first‐generation Libre flash glucose monitoring sensors were provided 3–4 months apart with a food, activity diary, user evaluation survey and treatment modification after each sensor wear. T‐tests were used to compare glucose variables within each sensor (week 1 vs. week 2) and between sensors (1st sensor vs. 2nd sensor). EasyGV software was used to calculate glycaemic variability. Results: From 42 type 1 diabetes and 120 type 2 diabetes participants, there was no statistically significant change in mean HbA1c for participants with type 1 diabetes at 3–4 months after the 1st sensor but there was a statistically significant HbA1c reduction for participants with type 2 diabetes [−4 mmol/mol (−0.4%), p = 0.008], despite no statistically significant differences in carbohydrate intake, exercise frequency and duration. Greater reduction was seen in those with baseline HbA1c> 86 mmol/mol (10%) in both type 1 [−12 mmol/mol (−1.1%), p = 0.009] and type 2 diabetes [−11 mmol/mol (−1.0%), p = 0.001). Both type 1 and type 2 diabetes showed improvements in Glucose Management Indicator and percentage time‐above‐range when comparing week 1 versus week 2 of the same sensor. Higher scan frequency resulted in improved glycaemic parameters and certain measures of glycaemic variability. The majority of participants (85%) agreed that flash glucose monitoring is a useful device but only 60% were keen to use it for daily monitoring. Conclusion: Constant feedback from flash glucose monitoring improves glycaemic parameters within the first week of wear. Intermittent use 3–4 months apart resulted in greater improvements for those with higher baseline HbA1c.