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 Low-blood sugar, or hypoglycemia, can be dangerous in diabetics.
Sometimes called an insulin reaction, or insulin shock, severe cases
of hypoglycemia can lead to unconsciousness and seizures.
The new Freestyle Libre sensor, a small device that’s worn on the
upper arm, automatically checks blood sugar every 15 minutes and
stores the information. A separate reader device, when held close to
the sensor, can display current glucose level, glucose readings over
the past 8 hours, and whether glucose has been rising or falling.
This can be repeated as often as desired.
Patients’ "marked increase in self-monitoring frequency” after they
started using the Freestyle Libre device “resulted in an almost
immediate reduction in hypoglycemia both during day- and
night-time,” Dr. Jan Bolinder from Karolinska University Hospital in
Stockholm, Sweden told Reuters Health by email.
Dr. Bolinder and colleagues from 23 European hospitals compared the
new glucose monitoring technology to conventional self-monitoring of
blood glucose for prevention of hypoglycemia in 239 adults whose
type 1 diabetes was already well controlled.
They randomly assigned patients to use one technique or the other,
and they focused on the amount of time patients’ blood sugar was low
over a 24-hour period.
This "time in hypoglycemia" decreased by 38% – from almost 3.5 hours
per day to 2 hours per day – with the new monitoring system, but it
barely changed in the group that continued to use conventional
self-monitoring.
In fact, all measures of low blood sugar were significantly better
with flash glucose monitoring both during the day and overnight.
According to the September 12th report in The Lancet, time spent
with high blood sugar was also reduced to a greater extent in
patients in the flash monitoring group than with conventional
monitoring.
The researchers think these improvements resulted from increased
attention to blood glucose levels. Patients in the flash monitoring
group checked their blood sugar an average of 15 times a day,
compared with only about six times a day in the conventional
monitoring group.
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The reductions in time spent in hypoglycemia and hyperglycemia (high
blood sugar) did not translate into differences in hemoglobin A1c
levels, insulin doses, or quality-of-life between the groups,
however.
“For many individuals, hypoglycemia is a barrier to optimum glucose
control,” the researchers conclude. “Novel sensor-based systems to
monitor glucose hold great promise as an effective alternative to
conventional self-monitoring of blood glucose.”
“My guess is that this type of device will replace conventional
(finger-prick) self-monitoring of capillary blood glucose in
subjects with insulin-treated diabetes in the near future,” Dr.
Bolinder said.
Dr. Roman Hovorka from the University of Cambridge in the UK, who
coauthored a commentary published with the study, told Reuters
Health, "For those who are very well controlled, wearing Libre
reduces hypoglycemia and promotes frequent glucose monitoring. The
device tends to be (nearly) cost neutral – this is great benefit
driving adoption even if not reimbursed.”
The Freestyle Libre sensor is manufactured by Abbott and is
presently available only in Europe, although the company is working
to get it approved in the United States. Abbott sponsored the study
and has financial relationships with all of the researchers.
SOURCE: http://bit.ly/2cprAUS and http://bit.ly/2cKDfhI The Lancet,
online September 12, 2016.
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