The majority of children/adolescents with type 1 diabetes failed in achieving optimal glycemic control.This study aims to observe the usefulness of 18-month usage of freestyle libre-flash glucose monitoring system FSL in pediatric and adolescent diabetics assessing the benefit of users of FSL in lowering A1C.
A study included type 1 diabetes pediatric and adolescent, on insulin therapy, with mean A1C prior to the study more than 9 %. The patients divided into 2 groups, group 1 using FSL and group 2 not using it.
There was a significant difference in HbA1c percentage between the two groups after 6 months, 18 months period of time and average HbA1c after 18 months. Similarly, the median percentage difference in basal HbA1c percentage versus 18 months was significantly reduced (p=0.001) in diabetics using FSL-CGM (-8.33%) compared to the control group (-1.26%). Group 1 patients showed a significant decrease in HbA1c percentage in each time point when comparing basal HbA1c % with corresponding HbA1c % at each time point, whereas controls (group 2) showed no significant difference in HbA1c % at the 3-time points.
Estimated A1c by FSL-software at both 6 and 18 months time periods showed a significant correlation with A1C assayed in the blood at the same time point. The snapshot showed a significant difference in average glucose, % above the target and %within the target. However, the % below the target, the number of low glucose events and average hypoglycemia duration in minutes showed a low significant difference.
Our data revealed significant improvement in A1C of diabetic patients using FSL over 6 months period compared to diabetics who not using FSL. short-term results which showed a median % difference in A1C 6 month versus basal equals -7.96 %. However, regarding the long-term changes, continuous usage of FSL resulted in a fine adjustment in A1C.
Using FSL in diabetics with A1C >10% showed a median % difference -12.37% versus -5.6% in those within the same group with A1C ≤10% with a significant difference . In group 1, a significant drop noted in A1C and hence % average glucose was due to significant changes in both the data and the median % difference between 18 month versus basal as regards % of captured data above target and % in the target. However, the changes in hypoglycemia parameters had a low significant difference which is reassuring.
Blood glucose monitoring using FSL provides significant changes in A1C in diabetics without observed risk for hypoglycemia. These changes in A1C in patients using FSL can be attributed to the look beyond A1C which provides a move to control of diabetes based on a dynamic overview.
director of taif military hospitals
consultant pediatric endocrinology
Taif, Makkah, Saudi Arabia
Hamed Ali Alghamdi is a Distinguished Pediatric Endocrinologist, Grew up In Kingdom of Saudi Arabia, Received his Arab Board in pediatrics in 1998 and Saudi Board in pediatrics in 1999. After he received his qualification as a Pediatric Endocrinologist & Diabetes Specialist from King Faisal Specialist Hospital and Research Center in Riyadh in 2003, he proceeded so fast in his specialty with many collaborations both in practical fields in the Saudi military hospitals being Consultant Pediatric Endocrinologist & Diabetes at Al Hada Armed Forces Hospital and the Director of Armed Forces Hospitals - Taif Region and also academic fields being Collaborator Assistant Professor at Medicine College in Taif University and Chairman of the Local Committee for Pediatrics Fellowship in the Western Region of Saudi Arabia. Also he is an eminent Member of Saudi Society for Endocrine and Metabolic diseases and a Member of Saudi Society for Pediatric Medicine. He shared in many conferences and workshops nationally and internationally and has 9 international publications.