Flash glucose monitoring improves glycemic control and treatment satisfaction in non-insulin treated diabetes patients

Flash glucose monitoring, also called intermittently scanned continuous glucose monitoring (isCGM), is a type of glucose monitoring device that can measure glucose levels in the subcutaneous interstitial fluid through a sensor worn on the patient's back of the upper arm. It allows patients to get their current glucose trends and a graph of the glucose reading over the preceding 8 hours, and they can understand their rise in glucose after a meal or lowering from a physical exercise. Such features may motivate them to follow exercise and diet therapy.

If FGM use is effective for diabetes self-management and lifestyle improvement, it can also be expected to be effective in noninsulin-treated T2D patients. Based on this hypothesis, Ayaka Hayase, Nagoya University Graduate School of Medicine, Nagoya, Japan, and colleagues previously conducted an RCT analysing the effects of conventional self-monitoring of blood glucose (SMBG) and FGM on glycemic control in these patients. They showed that FGM use improved glycated haemoglobin (HbA1c) which was sustained after the cessation of glucose monitoring.

In the study, published in Primary Care Diabetes, the investigators analyzed the changes in various parameters with using FGM to clarify the factors that affect the improvement in glycemic control with FGM use. They used data from 48 of 49 participants with noninsulin-treated type 2 diabetes who were in the groups using FGM from the previous study.

The analysis led to the following findings:

• Analyses of the FGM data during the 12-week FGM provision period showed that the weekly mean blood glucose levels considerably decreased as early as 1 week compared with the baseline values, and this decline continued for 12 weeks.
• An enhancement in the Diabetes Treatment Satisfaction Questionnaire regarding the "willingness to continue the current treatment" score was significantly associated with the improvement in HbA1c at 12 and 24 weeks.
• HbA1c improvement was associated with an improvement in treatment satisfaction.
• Changes in HbA1c were correlated with the percentage of time CGM is active.

"Rapid and prolonged improvement in HbA1c with the FGM use was associated with improved satisfaction with continuing the current treatment in patients with noninsulin-treated type 2 diabetes," the researchers concluded.

Limitations of the study were that the study used previous trial data and the number of participants was limited. Also, they did not assess lifestyle changes in the participants.

They suggested performing a prospective study using FGM as an empowerment tool for diabetes self-management in the future to evaluate lifestyle improvement by FGM use and to clarify effective support in conjunction with the use of FGM.

Reference:

Hayase, Ayaka, et al. "Improved Glycemic Control After the Use of Flash Glucose Monitoring Accompanied By Improved Treatment Satisfaction in Patients With Non-insulin-treated Type 2 Diabetes: a Post-hoc Analysis of a Randomized Controlled Trial." Primary Care Diabetes, 2023.