National study proves technology can help those living with diabetes

National Study proves technology helps diabetes

A national study jointly led by Hull York Medical School and the Association of British Clinical Diabetologists has shown that the use of specialised technology can significantly improve the outcomes of those people living with Type 1 diabetes - increasing awareness of their condition, helping them to manage their diabetes and reducing their need for hospital treatment and admissions. 

According to Diabetes UK, more than 4.7million people in the UK have diabetes, and someone is diagnosed with diabetes every 2 minutes. Type 1 diabetes affects approximately 8% and is a condition which causes the level of glucose (sugar) in your blood to become too high. It happens when your body can't produce enough of a hormone called insulin, which controls blood glucose. You need daily injections of insulin to keep your blood glucose levels under control. 

Professor Thozhukat Sathyapalan, Professor of Diabetes, Endocrinology and Metabolism and Honorary Consultant Endocrinologist at Hull York Medical School who led the study, said: ‘Type 1 diabetes is a condition where someone has too much glucose – a type of sugar – in their blood because they are not producing insulin. Too much glucose in the blood can lead to complications such as sight loss, amputation, kidney failure, stroke and death. As well as the devastating impact this is having on patients, this is also impacting on NHS resources.’ 

The study aimed to assess the effectiveness of specialised technology in helping patients to manage their diabetes and thereby reducing the need for hospital treatment and/or admissions. The technology used was the FreeStyle Libre system.  

The national study is the first of its kind to look at the impact of FreeStyle Libre on multiple aspects of diabetes care and across a large population. The authors looked at data from over 10,000 FreeStyle Libre users from 101 NHS hospitals in the UK.  

Data was analysed to assess the patterns of use of FreeStyle Libre and to study its effect on glycaemic control, hypoglycaemia (or low blood sugar), diabetes-related distress, and hospital admissions due to hypoglycaemia and hyperglycaemia / diabetic ketoacidosis (DKA). Baseline data were available for a total of 10,370 FreeStyle Libre users.  

For those patients with over seven months of follow-up data, the following outcomes were observed: 

• A significant reduction in blood sugar levels  

• A substantial improvement in patient’s awareness of the physical signs of impending hypoglycaemia (or low blood sugar) 

• A reduction in patient-reported hypoglycaemic events which occur when blood glucose levels fall below the required level 

• A reduction in diabetes distress – feeling overwhelmed by the demands of living with diabetes and/or a feeling of failing with the diabetes routine  

• A significant reduction in paramedic callouts and hospital admissions due to hypoglycaemia and hyperglycaemia / diabetic ketoacidosis (DKA)  caused by low or high blood sugar 

Dr Harshal Deshmukh, NIHR Clinical Lecturer in Endocrinology and Diabetes at Hull York Medical School and first author of the study said: ‘In our analysis of the largest real-world data set observing FreeStyle Libre use in type 1 diabetes, we show that its use is associated with significant improvements in patients ability to monitor and control their blood glucose levels, their awareness of hypoglycaemia and symptoms, the prevalence of hypoglycaemia, and a reduction in hospital admissions. Along with reduction in blood sugar levels, the use of this technology also reduces the variation in blood sugar levels which, if sustained, could lead to fewer complications related to diabetes.’ 

The FreeStyle Libre system was made available on the NHS to patients with type 1 diabetes, who use insulin in 2017. While there are other glucose monitoring devices available, the advantages of the FreeStyle Libre system include lower costs and factory calibration, which removes the need for frequent painful finger pricks to calibrate. The sensor can be worn for 14 days.  

Professor Sathyapalan said: ‘These results apply to those patients with type 1 diabetes, whose diabetes is poorly controlled or those who suffer from complications such as frequent hypoglycaemia or fear of hypoglycaemia. They demonstrate that the use of the Freestyle Libre system can significantly improve the experiences of those living with type 1 diabetes, increasing awareness and understanding, aiding self- management of the condition and reducing pressure on the NHS in terms of the ongoing management and treatment of patients with diabetes.’ 

The results of this national study can be found in the latest issue of Diabetes Care. 
Deshmukh H et al (2020).  https://care.diabetesjournals.org/lookup/doi/10.2337/dc20-0738