959-P: The Association of British Clinical Diabetologists' Audit of Freestyle Libre in Diabetes in United Kingdom—Effect on Hypoglycaemia Awareness

Abstract

The FSL flash glucose monitoring device can reduce hypoglycaemia in people with diabetes. This national audit explores UK real world experience of FSL with respect to hypoglycaemia awareness in people with diabetes. Clinicians using FSL were invited to submit data to a secure web-based tool held within the NHS N3 network. Data were analysed from available initial submissions from the 60 out of 120 NHS trusts registered for the audit. R3.5 was used for statistical analysis and T-test and Mann Whitney-U tests was used to compare the baseline and follow-up GOLD score and brief Diabetes Distress Screening Score (DDSS) respectively. Data were available for 2,438 (2,348 people with type 1 diabetes) FSL users; age 34(IQR =19-51) years, 54% female, diabetes duration 14 (IQR=19-51) years, and BMI of 24(IQR=21-28) kg/m2. In those with follow-up and baseline GOLD score (n=566), the median Gold score decreased significantly from 3.29(±1.85) at baseline to 2.79(±1.91), P<0.0001. Of those with GOLD score ≥4 (impaired awareness of hypoglycaemia) (n=228) at baseline, 23 (10%) improved their hypoglycaemia awareness (GOLD score of <4) following FSL initiation. From the user feedback questionnaire 78% reported that with use of FSL they were able to reduce the proportion of time in hypoglycaemia, 33% had been able to reduce rate of hypoglycaemia and 32% had reduced nocturnal hypoglycaemia. The initiation of FSL was associated with significant improvement in diabetes-related emotional distress with significant improvement [3 (2-4) at baseline to 2 (1-3) at follow-up P<0.0001] in both components of brief DDSS. These initial FSL audit data demonstrated a significant improvement in GOLD score and hypoglycaemic awareness following introduction of the FSL. Ongoing data collection and analysis will help explain if this transforms into reduced rate of hospital admissions and third party assistance due to hypoglycaemia and will inform future clinical practice and policy. Disclosure E.G. Wilmot: Advisory Panel; Self; Dexcom, Inc. Research Support; Self; Diabetes UK. Speaker's Bureau; Self; Abbott, Eli Lilly and Company, Novo Nordisk Inc., Sanofi. H. Deshmukh: None. D. Bishop: None. D.W. Lipscomb: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. Stock/Shareholder; Self; ABCAM, EKF Diagnostics, GlaxoSmithKline plc., Renalytix AI PLC. R. Banatwalla: None. R. Zaidi: None. Z.V. Smith: None. L. Overend: Other Relationship; Self; Lilly Diabetes, Novo Nordisk Inc. S. Kamaruddin: None. C.M. Hall: None. A. Kilvert: Advisory Panel; Self; Sanofi. J. Macfadyen: None. T. Sathyapalan: Speaker's Bureau; Self; Novo Nordisk Foundation. Other Relationship; Self; Bristol-Myers Squibb Company, Eli Lilly and Company, Sanofi-Aventis. C. Walton: Advisory Panel; Spouse/Partner; Celgene Corporation. Speaker's Bureau; Spouse/Partner; Leo Pharma, Novartis Pharmaceuticals Corporation. R.E. Ryder: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Bioquest.