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TOPLINE:
Use of the intermittently scanned continuous glucose monitor Freestyle Libre (FSL) was associated with improved glycaemic outcomes across all age groups. Individualised targets may be needed to improve time below range (TBR) in those older than 65 years.
METHODOLOGY:
Examination of Libreview account data for 947 adults aged ≤ 65 years and 114 aged > 65 years with type 1 or type 2 diabetes who had been using the FSL for > 6 months.
TAKEAWAY:
In both groups, similar proportions of patients achieved the time in range (TIR) target of > 70% (23.2% for ≤ 65 years vs 23.0% for < 65 years) and target of > 50% (63.0% vs 69.0% for ≤ 65 years and > 65 years, respectively).
But by age-specific targets, 23.2% of those aged ≤ 65 years achieved the age-specific TIR target of > 70% vs 69% of those aged > 65 years achieving the age-specific target of > 50% TIR.
The TBR target of < 4% was achieved by 70.1% of those aged ≤ 65 years vs 75.2% of those aged > 65 years, but among the older group, just 40.7% achieved the stricter TBR target of < 1%.
The time above range (TAR) goal of < 25% was achieved by 24.1% of the younger group and 24.3% of the older group, whereas the stricter < 10% TAR target was achieved in only 4.5% of the > 65 years group.
IN PRACTICE:
“Non-invasive glucose monitoring has revolutionised the management of type 1 and type 2 diabetes offering greater convenience to patients and more importantly encouraging self-management and improving glycaemic outcomes. Our data show that these benefits are extended to all age groups, particularly in older adults and those with long-standing diabetes who are at greater risk for hypoglycaemia,” the authors wrote. “It should be noted that the other than the mean change in HbA1c post-FSL, the p values do not hold statistical power and so there are limited conclusions to draw from these percentages. However, on a service evaluation level, it is a helpful insight as to where glycaemic control could be improved,” they added.
SOURCE:
The study was conducted by Carol Wong, of Birmingham Heartlands Hospital, University of Birmingham, UK, and colleagues. It was published online August 20, 2024, in Therapeutic Advances in Endocrinology and Metabolism.
LIMITATIONS:
Possible missing data from electronic health records. Disruptions due to the COVID-19 pandemic. No controls without intermittently scanned continuous glucose monitor. No examination of the interaction between diabetes duration and TBR.
DISCLOSURES:
The authors reported that there is no conflict of interest.
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