Diabetes refers to a set of health conditions related to the body’s ability to produce insulin, a hormone central to the metabolization of sugar, which helps with the provision of energy to the rest of the body, and is key to human survival.[1] With the right management, it’s possible to live a quality and healthy lifestyle with diabetes.[2] Management includes treatment, consistent diet management, regular exercise, and most importantly, glucose monitoring. [3] Continuous glucose monitoring is important for preventing against and stabilizing hyper and hypoglycemic conditions that can occur while living with diabetes.[4]
Unfortunately, conventional finger-prick blood sugar testing is both painful and inconvenient, and research shows that signifi cant numbers of patients find these to be deterrents [5], preventing needed patient-driven self-care, compromising not only quality of life, but also the health care providers’ capacity to provide proper and informed treatment [6]. However, recent research in medical science has explored the potential of technology and digital for providing pain and hassle-free [7] solutions for glucose monitoring, and it is showing promising results.
“When Abbott launched the FreeStyle Libre System in September 2014, we were driven by an ambitious purpose to transform the lives of millions of people with diabetes,” says Amjad Laimoun, Gulf, Iran & Pakistan Country Manager. “Six years on, FreeStyle Libre has liberated over 1.5 million [8] people from the hassle of routine finger-pricking, [9] and has become the leading sensor-based glucose monitoring system worldwide,”[10] he continues. The 2020 learned more about the FreeStyle Libre Link application, how people with diabetes and doctors are using it to monitor glucose levels on Smart phones.
How does the FreeStyle Libre System utilize smart tech to help people with diabetes manage their glucose levels?
FreeStyle Libre System requires no-fi nger-prick calibrations [9, 11], and is an easy way to check glucose with a painless 1-second scan.[12] The system is comprised of a reader or an application, [13] downloaded on smart phones used to scan a disposable sensor [14] worn on the back of the upper arm for up to 14 days. It automatically measures, captures and stores glucose data, day and night. Th e FreeStyle Libre System helps people manage their diabetes themselves discreetly [15] and provides a complete glycemic profile [16]. Together, this allows healthcare professionals to generate glucose reports on demand to help make more informed treatment decisions [17].
Why is continuous glucose monitoring a better option for people with diabetes?
Continuous monitoring with the FreeStyle Libre System makes it easy to identify trends and patterns in glucose fluctuations. This way, diabetes patients and caregivers can make informed decisions for treatment options as well as needed lifestyle changes. In addition to tracking daily patterns, with time-in-range data, both patients and doctors know when glucose readings tend to land above and below healthy levels. Data like this helps people with Type 1 [18] and Type 2 [19] diabetes, including reduced hypoglycemic conditions both day and night. Also Real-World Data show that users of the FreeStyle Libre system have improved glucose control increased time in target glucose range [20], and decreased time in hyperglycemia (high glucose levels) and hypoglycemia (low glucose levels) [21], as well as reduced HbA1C (average glucose levels over a three-month period). [22]
How is the Freestyle Libre a “Replacement” for existing blood glucose monitors?
A major obstacle to blood glucose monitoring is the pain and hassle of fi nger pricking that is necessary for getting a glucose reading5,23. Due to this inconvenient process, diabetes patients usually do not test as oft en as they should, and many therefore do not achieve optimal glycemic control. In fact, globally, the frequency of glucose monitoring falls short of European guidelines which states that testing should be between 4-8 times daily, and especially in insulin-treated patients.24 Only a third of patients adhere to glucose monitoring as recommended by their healthcare provider23 and two times this report skipping using a conventional glucose monitoring device because they fi nd it invasive.5 Altogether, less than a quarter of diabetes patients achieve their glycemic targets.25
How does the integration of continuous glucose monitoring with smartphone technology assist patients and doctors with making informed treatment decisions?
The FreeStyle Libre System empowers people with diabetes to regularly check their glucose levels themselves through a quick, pain-free12, and easy process. By removing the hassle of finger-pricking that conventional blood glucometers require, people are more engaged with monitoring their diabetes. The Flash Glucose Monitoring modality of the app improves the ability to collect information and facilitate compliance. At the same time, it equips doctors with real-time information on reports and glucose trends that are shared seamlessly and remotely via a cloud so they can better advise their patients on lifestyle improvements as well as optimize their treatment decisions based on those glucose trends.17
In this way, health care professionals can spend less time during appointments stressing the importance of daily testing and in return focus on providing streamlined management.
REFERENCES
© 2020 Abbott FreeStyle, Libre, and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdicti ons.
1.American Diabetes Associati on. Diabetes Overview. https://www.diabetes.org/diabetes
2.American Heart Associati on (2015) https://www.heart.org/en/health-topics/diabetes/preventi on--treatment-of-diabetes/living-healthy-with-diabetes.
3. American Diabetes Associati on Diabetes Care 2020
Jan; 43(Supplement 1): S48-S65. htt ps://doi.org/10.2337/dc20-S005
4. National Institute of Diabetes and Digesti ve and Kidney Disease. Conti nuous Glucose Monitoring. https://www.niddk.nih.gov/health- information/diabetes/overview/managing-diabetes/conti nuous-glucose-monitoring
5.Wagner J, Malchoff C., Abbott G. Invasiveness as a barrier to self-monitoring of blood glucose in diabetes. Diabetes Technol Ther. 2005;7(4):612-619.
6. Hortensius, Johanna., et al. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitati ve study. BMC Public Health 12.1 (2012):167
7. Data on file, Abbott Diabetes Care. In a study conducted by Abbott Diabetes Care, 99% of patients surveyed (n=123) agreed that the FreeStyle Libre system would reduce the hassles of glucose monitoring
8. Abbott Data on File
9. Bailey Timothy., et al. The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System. Diabetes Technology & Therapeuti cs. 2015;17(11):787-794.
10.Data based on the number of users worldwide for the FreeStyle Libre system compared to the number of users for other leading personal.
11. A finger prick test using a blood glucose meter is required during ti mes of rapidly changing glucose levels when intersti ti al fl uid glucose levels may not accurately refl ect blood glucose levels or if hypoglycaemia or impending hypoglycaemia is reported by the system or when symptoms do not match the system readings.
12. Data on file, Abbott Diabetes Care. In a study conducted by Abbott Diabetes Care, 92% of patients surveyed (n=119) pati ents agree that it was painless or almost painless to apply the sensor.
13.The FreeStyle LibreLink app is compati ble with NFC-enabled smartphones running Android OS 5.0 or later and with iPhone 7 and later running OS 11 and later. Use of FreeStyle LibreLink requires registrati on with LibreView, a service provided by Abbott and Newyu, Inc.The FreeStyle LibreLink app and the FreeStyle Libre reader have similar but not identi cal features. A finger prick test using a blood glucose meter is required during times of rapidly changing glucose levels when intersti ti al fl uid glucose levels may not accurately reflect blood glucose levels or if hypoglycaemia or impending hypoglycaemia is reported by the LibreLink app or when symptoms do not match the FreeStyle LibreLink app readings.
14. Data on fi le, Abbott Diabetes Care. 60-minute warm-up required when applying the sensor. Sensor is water resistant in up to 1 meter (3 feet) of water Do not immerse longer than 30 minutes. Not to be used above 10,000 feet.
15. In a study conducted by Abbott Diabetes Care, 91% of pati ents surveyed (n=123) agreed that using the FreeStyle Libre system is an easy and discreet way to check glucose.
16.Sensor has to be scanned at least once every 8 hours.
17.LibreView is compati ble with the latest versions of the Safari, Internet Explorer, Chrome, and Firefox web browsers running on Mac OS X Mountain Lion or later and Windows 7 or later. Use of FreeStyle LibreLink requires registrati on with LibreView, a cloud-based service developed by Newyu, Inc and provided by Abbott and Newyu, Inc. Data captured by FreeStyle LibreLink will be automati cally uploaded to LibreView when the phone on which it’s running is connected to the Internet.
18. Bolinder J, et al. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes a multi centre, non-masked, randomised controlled trial. Lancet. 2016;388(10057):2254-2263.
19. Haak T, Hanaire H, Aijan R. et al. Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes. Diabetes Ther. 2016. DOI 10.1007/s13300-016-0223-6.
20. Canadian real-world analysis of fl ash glucose monitoring and glycemic control; Lori Berard, Laura Brandner
21. Acute diabetes complicati ons defi ned by hypoglycemia, hypoglycemic coma, hyperglycemia, ketoacidosis, or hyperosmolarity ICD-10 codes as primary diagnosis for inpati ent or as any positi on in the outpati ent emergency claim; Matt hew Kerr, Gregory Roberts, Diana Souto, Yelena Nabutovsky.
22. Improving HbA1c control in people with Type 1 or Type 2 diabetes using flash glucose monitoring: a retrospecti ve observati onal analysis in two German centers; Gerhard Klausmann, Ludger Rose, Alexander Seibold
23. Vincze G, Barner JC, Lopez D. Factors associated with adherence to self-monitoring of blood glucose among persons with diabetes. Diabetes Educ. 2004;30(1):112-125.
24.Schnell O, Alawi H, Batt elino T, et al. Consensus statement on self-monitoring of blood glucose in diabetes. A European perspecti ve. Diabetes, Stoff wechsel und Herz. 2009;18(4):285-289. 25. Foster N, Beck R, Miller K, et al. State of type 1 diabetes management and outcomes from the T1D exchange in 2016–2018. Diabetes Technol Ther. Published online January 19, 2019. htt p:// doi.org/10.1089/dia.2018.0384.
*Scanning the sensor to obtain glucose levels does not require lancets. Images are for illustrati ve purposes only. Not real pati ent or Health Care Professional. Simulated data for illustrati ve purposes only. Not real patient or data.
