Implementation of flash glucose monitoring in four pediatric diabetes clinics: controlled before and after study to produce real-world evidence of patient benefit
Authors' conclusion
There was some indication that flash monitoring might help young people improve the control of their diabetes but for our sample, the difference between finger-prick testing and flash monitoring was not clinically significant (HbA1c improvement <5 mmol/mol). Given the pace of technological change within diabetes, research efforts should now facilitate the real-time analysis of long-term routine data on flash and continuous glucose monitors.
Study context
- Population
- Children aged 4–18 years with T1D, four paediatric diabetes clinics (secondary care), South West England
- Participants
- 114 vs 80
- Exposure
- Flash glucose monitoring vs self-monitoring of blood glucose (SMBG)
- Flash monitoringn = 114
- SMBG controlsn = 80reference
- Outcome
- Adjusted mean HbA1c (mmol/mol), before and after (≈12 months)
- Follow-up
- ≈12 months before and after
Methodological detailsreal-world, population-based, routinely collected health record data, 4 paediatric diabetes clinics
- Real-world
- Population-based
- Routinely collected health record data
- 4 paediatric diabetes clinics
Main finding
As reported in the abstract
Controls: adjusted mean HbA1c before
61.2 mmol/mol
Controls: adjusted mean HbA1c after
63.9 mmol/mol
Flash monitoring: adjusted mean HbA1c before
64.6 mmol/mol
Flash monitoring: adjusted mean HbA1c after
63.8 mmol/mol
Observational data: associations, not effects.
Further findings
| Outcome | Incremental costs |
|---|---|
| Incremental costsFlash monitoring vs Controls | +£841 |
- Incremental costs — 'After' flash vs flash 'before' incremental costs
- +£703
- Incremental costs: 'after' flash vs contemporaneous SMBG controls; driven by primary care prescribing (sensor costs)
- Incremental costs: cost differences driven by primary care prescribing (sensor costs)
Safety
Short-term complications (hypoglycaemia, DKA, related illness)
- Rates of short-term complications were low across all groups
Original publication
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