Diabetologia: Flash monitor is associated with improvement of glycosylated hemoglobin level and DKA rate in patients with type 1 diabetes

Purpose/Assumption: We evaluated the actual impact of the use of the flash monitor (FM) on the level of HbA1c, diabetic ketoacidosis (DKA) and the incidence of severe hospitalized hypoglycemia (SHH) in Scottish type 1 diabetic patients , And the incidence of severe hypoglycemia in different social and demographic strata in this population
.

We assessed the actual impact of the use of the flash monitor (FM) on the levels of HbA1c, diabetic ketoacidosis (DKA) and severe hospitalized hypoglycemia (SHH) in Scottish type 1 diabetic patients, as well as this population The incidence of severe hypoglycemia in different social and demographic strata in China
.

Methods: This study used retrospective, observational, and registration studies, using the National Diabetes Registry, and found 14,682 people who used FM at any time from 2014 to 2020
.

After the start of FM, the changes in the human body of HbA1c from the baseline were simulated using a linear mixed model, which also considered the trajectory of the human body before exposure

Results: By mid-2020, the proportion of people who have used FM is 45.
9%, and there are big differences in age and socioeconomic status: 64.
3% of children under 13 years old, 32.
7% of children 65 years or older, respectively; the poorest quintiles are respectively They are 54.
4% and 36.
2%
.

Overall, in the second year after the start of FM, the median change of glycosylated hemoglobin in the body is −2.

Figure 1 Compared with the baseline in HbA1, the change in the coverage time of HbA1 with and without FM exposure in humans starting from FM
.

The data is the median (IQR)

Figure 1 Compared with the baseline in HbA1, the change in the coverage time of HbA1 with and without FM exposure in humans starting from FM

Figure 2 The estimated fold change (95% CI) of HbA1c in the first year after the start of FM, compared with the pre-exposure level, adjusted according to the pre-exposure trend, baseline HbA1c, age, gender, and diabetes course, and according to the age at the start of FM Stratified by segment (A), gender (B), SIMD quintile (C), previously used pump (D), status of previously completed diabetes education program (E), and early adopter status (F)

Figure 2 The estimated fold change (95% CI) of HbA1c in the first year after the start of FM, compared with the pre-exposure level, adjusted according to the pre-exposure trend, baseline HbA1c, age, gender, and diabetes course, and according to the age at the start of FM Stratified by segment (A), gender (B), SIMD quintile (C), previously used pump (D), status of previously completed diabetes education program (E), and early adopter status (F)

Figure 3 The incidence of crude DKA events (95% CI) of FM users before and after the start of FM, based on baseline HbA1c (A), age at FM start (B), gender (C), SIMD quintile (D), Prior use of the pump (E), previously completed diabetes education program status (F), and early adopter status (G) stratified
.

Py, person/year

Figure 3 The incidence of crude DKA events (95% CI) of FM users before and after the start of FM, based on baseline HbA1c (A), age at FM start (B), gender (C), SIMD quintile (D), Prior use of the pump (E), previously completed diabetes education program status (F), and early adopter status (G) stratified

The initiation of FM is associated with a clinically important reduction in HbA1c and a significant reduction in the DKA rate

Jeyam A, Gibb FW, McKnight JA,et al.

Flash monitor initiation is associated with improvements in HbA levels and DKA rates among people with type 1 diabetes in Scotland: a retrospective nationwide observational study.
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