Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5)
Aims: To identify factors predicting HbA1c reduction in patients with diabetes mellitus (DM) using FreeStyle Libre Flash Glucose Monitoring (FSL-FGM). Methods: Data from a 12-month prospective nation-wide FSL registry were used and analysed with multivariable regression. For the present study we inc...
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doaj-3776132a7c774cf3bb28c0adcf647c3a2020-12-17T04:49:32ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372020-12-0122100237Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5)A. Lameijer0M.J. Fokkert1M.A. Edens2R.J. Slingerland3H.J.G. Bilo4P.R. van Dijk5University of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, The Netherlands; Corresponding author at: University of Groningen, University Medical Center, Dept. of Endocrinology, Hanzeplein 1, 9700 RB, HP AA30 Groningen, The Netherlands.Isala, Department of Clinical Chemistry, Zwolle, The NetherlandsIsala, Department of Innovation and Science, Zwolle, The NetherlandsIsala, Department of Clinical Chemistry, Zwolle, The NetherlandsUniversity of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands; Isala, Diabetes Research Center, Zwolle, The NetherlandsUniversity of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, The Netherlands; Isala, Diabetes Research Center, Zwolle, The NetherlandsAims: To identify factors predicting HbA1c reduction in patients with diabetes mellitus (DM) using FreeStyle Libre Flash Glucose Monitoring (FSL-FGM). Methods: Data from a 12-month prospective nation-wide FSL registry were used and analysed with multivariable regression. For the present study we included patients with hypoglycaemia unawareness or unexpected hypoglycaemias (n = 566) and persons who did not reach acceptable glycaemic control (HbA1c > 70 mmol/mol (8.5%)) (n = 294). People with other indications for use, such as sensation loss of the fingers or individuals already using FSL-FGM or rtCGM, were excluded (37%). Results: Eight hundred and sixty persons (55% male with a mean age of 46.7 (±16.4) years) were included. Baseline HbA1c was 65.1 (±14.5) mmol/mol (8.1 ± 1.3%), 75% of the patients had type 1 DM and 37% had microvascular complications. Data concerning HbA1c was present for 482 (56.0%) at 6 months and 423 (49.2%) persons at 12 months. A significant reduction in HbA1c (≥5 mmol/mol (0.5%)) was present in 187 (22%) persons. For these persons, median HbA1c reduction was −9.0 [−13.0, −4.0] mmol/mol (−0.82 [−1.19, −0.37]%) at 6 months and −9.0 [−15.0, −7.0] mmol/mol (−0.82 [−1.37, −0.64]%) at 12 months. In multivariable regression analysis with age, gender and SF-12 physical and mental component scores as covariates, only baseline HbA1c was significant: −0.319 (SE 0.025; p < 0.001; R2 = 0.240 for the model). In exploratory analysis among subgroups with different indications for FSL-FGM use (hypoglycaemia unawareness or persistently high HbA1c) and persons with a significant HbA1c decrease over the study period, baseline HbA1c remained the only significant predictor. Conclusions: Among the variables we analysed in the present study, only high HbA1c at baseline predicts significant HbA1c reduction during FSL-CGM use.http://www.sciencedirect.com/science/article/pii/S2214623720300909Type 1 diabetesFreeStyle LibreFlash glucose monitoringContinuous glucose monitoring |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
A. Lameijer M.J. Fokkert M.A. Edens R.J. Slingerland H.J.G. Bilo P.R. van Dijk |
spellingShingle |
A. Lameijer M.J. Fokkert M.A. Edens R.J. Slingerland H.J.G. Bilo P.R. van Dijk Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) Journal of Clinical & Translational Endocrinology Type 1 diabetes FreeStyle Libre Flash glucose monitoring Continuous glucose monitoring |
author_facet |
A. Lameijer M.J. Fokkert M.A. Edens R.J. Slingerland H.J.G. Bilo P.R. van Dijk |
author_sort |
A. Lameijer |
title |
Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) |
title_short |
Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) |
title_full |
Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) |
title_fullStr |
Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) |
title_full_unstemmed |
Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5) |
title_sort |
determinants of hba1c reduction with freestyle libre flash glucose monitoring (flare-nl 5) |
publisher |
Elsevier |
series |
Journal of Clinical & Translational Endocrinology |
issn |
2214-6237 |
publishDate |
2020-12-01 |
description |
Aims: To identify factors predicting HbA1c reduction in patients with diabetes mellitus (DM) using FreeStyle Libre Flash Glucose Monitoring (FSL-FGM). Methods: Data from a 12-month prospective nation-wide FSL registry were used and analysed with multivariable regression. For the present study we included patients with hypoglycaemia unawareness or unexpected hypoglycaemias (n = 566) and persons who did not reach acceptable glycaemic control (HbA1c > 70 mmol/mol (8.5%)) (n = 294). People with other indications for use, such as sensation loss of the fingers or individuals already using FSL-FGM or rtCGM, were excluded (37%). Results: Eight hundred and sixty persons (55% male with a mean age of 46.7 (±16.4) years) were included. Baseline HbA1c was 65.1 (±14.5) mmol/mol (8.1 ± 1.3%), 75% of the patients had type 1 DM and 37% had microvascular complications. Data concerning HbA1c was present for 482 (56.0%) at 6 months and 423 (49.2%) persons at 12 months. A significant reduction in HbA1c (≥5 mmol/mol (0.5%)) was present in 187 (22%) persons. For these persons, median HbA1c reduction was −9.0 [−13.0, −4.0] mmol/mol (−0.82 [−1.19, −0.37]%) at 6 months and −9.0 [−15.0, −7.0] mmol/mol (−0.82 [−1.37, −0.64]%) at 12 months. In multivariable regression analysis with age, gender and SF-12 physical and mental component scores as covariates, only baseline HbA1c was significant: −0.319 (SE 0.025; p < 0.001; R2 = 0.240 for the model). In exploratory analysis among subgroups with different indications for FSL-FGM use (hypoglycaemia unawareness or persistently high HbA1c) and persons with a significant HbA1c decrease over the study period, baseline HbA1c remained the only significant predictor. Conclusions: Among the variables we analysed in the present study, only high HbA1c at baseline predicts significant HbA1c reduction during FSL-CGM use. |
topic |
Type 1 diabetes FreeStyle Libre Flash glucose monitoring Continuous glucose monitoring |
url |
http://www.sciencedirect.com/science/article/pii/S2214623720300909 |
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