EVALUATING THE EFFICACY OF FREE STYLE LIBRE FLASH GLUCOSE MONITORING IN THE OLDER POPULATION

ABSTRACT

Background and Aims: Background: Frailty associated with older age increases the risk of complications for diabetes and its treatment, in particular hypoglycaemia. Free Style Libre is a form of flash glucose monitoring that has been commissioned for use in people living with type 1 diabetes who meet NHS criteria and can reduce hypoglycaemia. Aims: Evaluate whether patients ≥65-years-old across Birmingham Heartlands Hospital (BHH) and Solihull Hospital (SOL) are meeting AATD time in range CGM targets. Methods: BHH and SOL patients ≥65-years-old using Free-Style Libre until June 2021 were included in the study population. Patient data such as average scans per day, TIR, TAR, TBR and time <3.0mmol/L were transferred from Libreview. Demographic and HbA1c data were retrieved from electronic patient records. Results: 65 patients were identified, 44 were eligible for inclusion. 68.2% (30/44) met the TIR target of >50%, 45.5% (20/ 44) met the TAR target of <10% and 18.2% (8/44) met the TBR target of <1%. Further analysis of TBR, comparing patients to the AATD recommendation for younger people, found that 75% (33/ 44) spent <4% of time below range. 18.2% (8/44) spent <1% in hypoglycaemia (<3mmol/L) and 81.8% (36/44) spent ≥1% in hypoglycaemia. Conclusions: Despite using Free Style Libre, older patients remain at significant risk of hypoglycaemia. This risk should be managed in outpatient clinics using hypo-awareness and frailty scores. Free Style Libre data can be used as per the ABCD risk stratification criteria for triaging these patients with high risk hypoglycaemia during the COVID-19 recovery phase.