Positive impact of Flash glucose monitoring

New study reveals positive impacts of Flash glucose monitoring on blood sugar and quality of life

• Researchers compared finger prick testing to Flash glucose monitoring with optional alarms (FreeStyle Libre 2), tech used by more than half of people living with type 1 diabetes in England.
• Results show Flash helped people with type 1 diabetes to lower their overall blood glucose levels. They were able to spend more time in the glucose target range, with less high and low glucose levels.
• People using the Flash also reported improved diabetes treatment satisfaction.
• These improvements are likely to reduce the risk of developing long-term diabetes complications.

New research published in the New England Journal of Medicine, has revealed the life-changing benefits of Flash blood glucose (sugar) monitoring for people with type 1 diabetes.

The findings reveal that Flash – which allows people to see their blood sugar levels by scanning their sensor – not only helps improve overall blood glucose levels by reducing both high and low glucose levels in people with type 1 diabetes, but also has a positive effect on their treatment satisfaction. Importantly these improvements were seen without an increase in the amount of insulin used, suggesting glucose data obtained by the Flash monitor allowed people to adjust their therapy to improve their outcomes. It is likely that the benefits seen in this study will lead to a reduction in the risk of future diabetes complications.

Funded by Diabetes UK, Dr Lalantha Leelarathna and a team of investigators from eight UK centres (Birmingham, Cambridge, Derby, Dorset, Ipswich, Manchester, Norwich and Portsmouth) conducted a randomised controlled trial to understand how second-generation Flash technology compares to traditional finger prick testing for helping people with type 1 diabetes to manage their condition.

The trial involved 156 people with type 1 diabetes who had above-target blood glucose levels. For 24 weeks, half of the participants monitored their glucose levels with Flash and the other half continued using finger prick blood testing.

At the start of the study both groups had similar 3-month average blood glucose levels (assessed by an HbA1c blood test).

After 24 weeks, those participants who used Flash had reduced their HbA1c from an average of 8.7% to 7.9%, a reduction of 0.8 percentage points. Lowering HbA1c by this amount can decrease the risk of developing diabetes complications in the future by up to 40%. In comparison, those in the finger prick group had reduced their HbA1c on average by only 0.2 percentage points by the end of the study. (Between group difference of 0.5 percentage points).

In addition, those using the Flash technology spent an extra 130 minutes a day with their blood glucose levels in the target range (between 3.9 and 10 mmol/L) and 43 minutes per day less with dangerously low blood glucose levels (below 3.9 mmol/L).

The researchers further discovered that Flash had a positive impact on quality of life. Participants in the Flash group reported they were happier with their diabetes treatment and that using the technology improved glucose monitoring satisfaction.

Type 1 diabetes is a serious and life-long condition, that currently affects more than 300,000 people in the UK. Close monitoring of blood glucose levels is an essential – but often disruptive – part of daily life for people living with it in order to avoid complications.

Flash involves a small sensor that sits just underneath the skin and continuously measures glucose in the fluid that surrounds the body’s cells. To get a reading, users painlessly flash a reader or smartphone over the sensor to see what blood glucose levels are doing minute by minute. The device will also alert people when their levels are going too low or too high.

Flash glucose monitoring technology was first made available through the NHS in 2017. Currently, more than half of people living with type 1 diabetes are prescribed Flash on the NHS in England. In March 2022, the National Institute of Health and Care Excellence (NICE) recommended Flash or other continuous glucose monitoring for use in all adults with type 1 diabetes, and Flash for some people with type 2 diabetes who have two or more insulin injections a day.

Dr Elizabeth Robertson, Director of Research at Diabetes UK, which funded the study, said:

“This study confirms the radical improvements Flash can bring to the lives of people living with type 1 diabetes, helping them to reduce their blood glucose levels – protecting against short and long-term diabetes complications – and removing some of the relentless burden of managing the condition.

“It is crucial that everyone who is eligible for this transformative technology is able to access it. Following NICE’s recommendation of Flash or CGM for all adults with type 1 diabetes, these results are a reminder of the benefits of this innovative technology, driving home the importance of equitable access to this life-changing intervention across the UK.”

Dr Lalantha Leelarathna, Diabetes UK-funded researcher at the University of Manchester, said:

“Ability to monitor glucose without painful finger-sticks is life-changing for many people living with type 1 diabetes. With the use of second generation intermittently-scanned continuous glucose monitoring (also known as Flash glucose monitoring), we found significant improvements in average glucose levels and a reduction in both high and low glucose levels, helping people to spend more time with normal glucose levels. Further treatment satisfaction and glucose monitoring satisfaction were also higher in those using glucose sensors. We call for universal funding of this life-changing technology for all people living with type 1 diabetes across the world. Further work is underway to assess the cost-effectiveness of this technology.”