Practicalities of Flash-monitoring systems utilization in the questionnaire survey of children and adolescents with type 1 diabetes mellitus
https://doi.org/10.14341/DM12889
Abstract
BACKGROUND: Children and adolescents with type 1 diabetes mellitus (T1DM) are recommended to perform self-control 6–10 times a day to maintain optimal blood glucose levels. Currently, there are various devices, such as glucometers, systems for continuous blood glucose monitoring and flash monitoring (FMS). In real clinical practice patients can combine the use of various devices and face with problems of their exploitation.
AIM: To investigate the peculiarities of FMS utilization by children and adolescents with T1DM using questionnaire survey.
MATERIALS AND METHODS: From 06.2020 till 05.2021, a survey of patients with T1DM was conducted as part of a single-center, observational, one-stage, uncontrolled study. The questionnaire contained questions regarding the number of measurements, circumstances and adverse reactions when using the devices.
RESULTS: We questioned 80 patients (47 girls and 33 boys) aged 11.7 (9.0; 14.0) years with DM1 for 4.9 (2.0; 7.0) years, HbA1c level 8.2 (6.8; 9.0)) which were in pediatric endocrinology department of the University Children’s Clinical Hospital.
The majority of patients (86.3%) scan the sensor more than 10 times a day; 25% of FMS-users measure blood glucose with glucometer not every day.
The majority of patients (51,3%) prefer to use FMS instead of glucometer in all circumstances. Patients face with errors using FMS more often than using glucometers — OR 3.4 (95% CI 1.7–6.8). Non-significant reaction to adhesive material disturbed 50.0% participants; one patient (1.3%) had to refuse FMS due to allergic reaction.
Among possible reasons to refuse FMS patients often name error, skin sealing, high price, inflammation, inconvenience to wear a device.
Additional measures for fixing FMS device are always used by 36,3% of patients, sometimes — 18,8%, in some situations (going in for sports, swimming, travelling, in case of unsticking at the end of term) — 15,0%.
CONCLUSION: Quarter of FMS users double-check glycaemia values rarer than recommended. Patients face with error using FMS more often than using glucometer. Local reaction to adhesive material does not influence FMS utilization. The majority of patients use additional measures for fixing FMS devices.
About the Authors
A. M. RimskayaRussian Federation
Alena M. Rimskaya - clinical resident.
19 B. Pirogovskaya street, 119881 Moscow
Competing Interests:
none
A. E. Krasnovidova
Russian Federation
Anastasia E. Krasnovidova - clinical resident.
Moscow
Competing Interests:
none
A. V. Vitebskaya
Russian Federation
Alisa V. Vitebskaya - MD, PhD, Associate Professor.
Moscow
Competing Interests:
none
References
1. Rossiiskaia assotsiatsiia endokrinologov. Klinicheskie rekomendatsii. Sakharnyi diabet 1 tipa u detei (diagnostika i lechenie). Moscow: Ministerstvo zdravookhraneniia RF; 2021. (In Russ.).
2. DiMeglio LA, Acerini CL, Codner E, et al. ISPAD clinical practice consensus guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes. 2018;19(6):105-114. doi: https://doi.org/10.1111/pedi.12737
3. Aleppo G, Ruedy KJ, Riddlesworth TD, et al. REPLACE-BG: A randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in adults with well-controlled type 1 diabetes. Diabetes Care. 2017;40(4):538-545. doi: https://doi.org/10.2337/dc16-2482
4. Hirsch I, Battelino T, Peters A, et al. Role of continuous glucose monitoring in diabetes treatment. Arlington (VA): American Diabetes Association; 2018. doi: https://doi.org/10.2337/db20181
5. Bailey T, Bode BW, Christiansen MP, etv al. the performance and usability of a factory-calibrated Flash glucose monitoring system. Diabetes Technol Ther. 2015;17(11):787-794. doi: https://doi.org/10.1089/dia.2014.0378
6. Peterkova VA, Ametov AS, Mayorov AY, et al. The scientific advisory board resolution: Implementation of intermittently scanned Continuous Glucose monitoring in clinical practice to improve glycemic control. Diabetes mellitus. 2021;24(2):185-192. (In Russ.). doi: https://doi.org/10.14341/DM12753
7. Laptev DN, Emelyanov AO, Andrianova EA, et al. The use of Flash glucose monitoring in children with type 1 diabetes mellitus in real clinical practice. Diabetes mellitus. 2021;24(6):504-510. (In Russ.). doi: https://doi.org/10.14341/DM12817
8. Laptev DN, Bezlepkina OB, Demina ES, et al. Evaluation of FreeStyle Libre in pediatric t1dm: improved glycemic control, reduction in diabetic ketoacidosis and severe hypoglycemia. Problems of Endocrinology. 2022;68(3):86-92. (In Russ.). doi: https://doi.org/10.14341/probl12877
9. Clarke SF, Foster JR. A history of blood glucose meters and their role in self-monitoring of diabetes mellitus. Br J Biomed Sci. 2012;69(2):83-93. doi: https://doi.org/10.1080/09674845.2012.12002443
10. ISO 15197:2013(En) In vitro diagnostic test systems — Requirements for blood-glucose monitoring systems for self-testing in managing diabetes mellitus. Geneva: International Organization for Standardization; 2013. Available at: https://www.iso.org/obp/ui/#iso:std:iso:15197:ed-2:v1:en. Accessed 11.01.2023.
11. Shah VN, Laffel LM, Wadwa RP, Garg SK. Performance of a factory-calibrated real-time continuous glucose monitoring system utilizing an automated sensor applicator. Diabetes Technol Ther. 2018;20(6):428-433. doi: https://doi.org/10.1089/dia.2018.0143
12. Al Hayek AA, Robert AA, Al Dawish MA. Evaluation of FreeStyle Libre Flash Glucose Monitoring System on Glycemic Control, Health-Related Quality of Life, and Fear of Hypoglycemia in Patients with Type 1 Diabetes. Clin Med Insights Endocrinol Diabetes. 2017;10(6):117955141774695. doi: https://doi.org/10.1177/1179551417746957
13. Vergier J, Samper M, Dalla-Vale F, et al. Evaluation of flash glucose monitoring after long-term use: A pediatric survey. Prim Care Diabetes. 2019;13(1):63-70. doi: https://doi.org/10.1016/j.pcd.2018.08.004
14. Marsters BL, Boucher SE, Galland BC, et al. The ‘flash’ adhesive study: a randomized crossover trial using an additional adhesive patch to prolong freestyle libre sensor life among youth with type 1 diabetes mellitus. Acta Diabetol. 2020;57(11):1307-1314. doi: https://doi.org/10.1007/s00592-020-01556-y
15. Bolinder J, Antuna R, Geelhoed-Duijvestijn P, et al. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet. 2016;388(10057):2254-2263. doi: https://doi.org/10.1016/S0140-6736(16)31535-5
16. Klonoff DC, Parkes JL, Kovatchev BP, et al. Investigation of the Accuracy of 18 Marketed Blood Glucose Monitors. Diabetes Care. 2018;41(8):1681-1688. doi: https://doi.org/10.2337/dc17-1960
17. Jadviscokova T, Fajkusova Z, Pallayova M, et al. Occurence of adverse events due to continuous glucose monitoring. Biomed Pap. 2007;151(2):263-266. doi: https://doi.org/10.5507/bp.2007.044
18. Schwensen JF, Friis UF, Zachariae C, Johansen JD. Sensitization to cyanoacrylates caused by prolonged exposure to a glucose sensor set in a diabetic child. Contact Dermatitis. 2016;74(2):124-125. doi: https://doi.org/10.1111/cod.12503
19. Seibold A. Minimizing Adverse Skin Reactions to Wearable Continuous Glucose Monitoring Sensors in Patients With Diabetes. J Diabetes Sci Technol. 2021;15(3):713-714. doi: https://doi.org/10.1177/1932296820984763
20. Asarani NAM, Reynolds AN, Boucher SE, et al. Cutaneous complications with continuous or flash glucose monitoring use: Systematic review of trials and observational studies. J Diabetes Sci Technol. 2020;14(2):328-337. doi: https://doi.org/10.1177/1932296819870849
Supplementary files
|
1. Figure 1. Frequency of glucose measurements. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(168KB)
|
Indexing metadata ▾ |
|
2. Figure 2. Situations when patients would prefer to use flash glucose monitoring. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(189KB)
|
Indexing metadata ▾ |
|
3. Figure 3. Problems with flash glucose monitoring. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(168KB)
|
Indexing metadata ▾ |
|
4. Figure 4. Possible reasons for not using flash glucose monitoring. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(219KB)
|
Indexing metadata ▾ |
|
5. Figure 5. Patients distribution by the frequency of the use of additional means for fixing the flash glucose monitoring sensor. | |
Subject | ||
Type | Исследовательские инструменты | |
View
(73KB)
|
Indexing metadata ▾ |
Review
For citations:
Rimskaya A.M., Krasnovidova A.E., Vitebskaya A.V. Practicalities of Flash-monitoring systems utilization in the questionnaire survey of children and adolescents with type 1 diabetes mellitus. Diabetes mellitus. 2023;26(1):39-48. (In Russ.) https://doi.org/10.14341/DM12889

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).