2293-PUB: Evaluation of Utility of Flash Glucose Monitoring (FGM) in People with Type 2 Diabetes in an Urban Indian Setting

Abstract

The scientific utility of Self-Monitoring of Blood Glucose (SMBG) has been recently challenged by scientific reports. Therefore, we aimed to understand the utility of FGM in Indian setting. FGM is a standard care of practice at our center to deliver effective metabolic care. We analyzed the FGM reports (Libre Pro) from the LINA cohort (n=102; males 67, females 35), to understand the impact of measures adopted for glycemic control. We compared the baseline HbA1c with the repeat HbA1c when the patients reported for at least one follow-up within six months, of undergoing the FGM and being recommended changes in lifestyle with appropriate therapeutic changes, on the basis of FGM findings. Statistical analysis was performed by student t test. The mean age was 60 years (SD±13, 95% CI 57-62). Mean duration of diabetes 13 years (SD±9.2, 95% CI 11-15). The mean baseline HbA1c 8.5% (SD±1.5, 95% CI 8.2-8.8) significantly reduced to mean HbA1c 8% (SD±1.4, 95% CI 7.7-8.3) (p=0.144). Mean reduction in HbA1c was -0.5% (SD±1.4, 95% CI -0.78 to -0.22). Out of 102 patients for HbA1c comparison for change in HbA1c, 68 reported reductions in HbA1c of which 47 (69%) reported HbA1c reductions greater than 0.5%. We corroborated the reported estimated HbA1c (eHbA1c) from Libre Pro with conventional HbA1c reports at follow-up. The higher mean difference in HbA1c of 0.82%, does not justify the utility of eHbA1c in FGM. This often is a misleading tool and a deterrent to efficacious glycemic care. The greater adoption of FGM in our setting empowered patients to choose a healthy lifestyle and the health care professionals to judiciously customize the therapy, with reduction in glycemic variability and increasing the time in range. The rationality of the utility of eHbA1c, which has been questioned in our real-world data, need to be addressed through a higher level of evidence by a larger, nation- wide prospective multicentric study. Disclosure M. Chawla: None. P.M. Chawla: None. A. Shah: None.