Use of FGMS (Freestyle Libre) in Children and Young People with Type 1 Diabetes Mellitus-a UK DGH Experience
Data was retrospectively collected from Electronic Patient Records for a 12-month period between June 2017 and June 2018. There were 100 CYP’s with T1DM, of which 50 were commenced on FGMS. Funding sought appropriately before being commenced on sensor. CYP’s and families were also made aware of the fact that funding can be withdrawn after a 6-month trial period if outcomes were unmet. HbA1c at the start of the trial was compared with HbA1c at 3, 6 and 9 months.
Results: The HbA1c at the start of the trial was 65.1 mmol/mol; which showed an 8.1% improvement at 3 months, 12.3% at 6 months and 12.8% at 9 months. 67% discontinued the use of the FGMS, as qualitative evidence reported it to be unreliable. 2 of these children, recommenced the FGMS.
|
Male (n=20) |
Female (n=30) |
Total (n=50) |
|
|
Average age at start of trial |
13.6 |
11.3 |
12.8 |
|
HbA1C pre-sensor (mmol/mol) |
75.1 |
64.2 |
65.1 |
|
HbA1C at 3 months (mmol/mol) |
88.5 |
62.4 |
59.8 |
|
HbA1C at 6 months (mmol/mol) |
58.3 |
58.3 |
57.1 |
|
HbA1C at 9 months (mmol/mol) |
52.2 |
57.7 |
56.8 |
|
June 2018-19, 6 new patients were commenced FGMS |
|||
|
HbA1C pre-sensor (mmol/mol) |
84.5 |
65 |
71.5 |
|
HbA1C at 3 months (mmol/mol) |
40 |
54.3 |
49.5 |
|
HbA1C at 6 months (mmol/mol) |
46 |
52.3 |
50.5 |
Conclusion: Our data shows a reduction in HbA1C after 3 months of continuous sensor use which is maintained at 6 and 9 months. The improvement in HbA1c is marked if the sensor was started within 6 months of diagnosis compared to those who have had T1DM for longer. Education is crucial before the start of sensor so that families and CYP’s are well equipped to get the best out of it. The use of outcomes-based criteria as set by the CCG’s acts to incentivise families, CYP’s and HCP’s to improve control.
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