Flash glucose monitoring in diabetes: Insights in its impact on glucose control and well-being in persons with diabetes

Adequate and timely glucose level assessment is of utmost importance for persons with diabetes when aiming for optimal glycemic control and thus avoid or delay the development of micro- and macrovascular complications. In this thesis, the effects of Flash Glucose Monitoring (FGM) on glycemic control and well-being in persons with diabetes are explored. FGM is a form of continuous glucose monitoring that requires scanning of the glucose sensor to obtain information about
the glucose concentration in the interstitial fluid. In contrast to fingerprick (point) glucose measurements, FGM is more convenient, provides insight in glucose fluctuations and trends during day and night, and allows more frequent glucose level assessment. Previous studies on FGM had a limited follow-up period and were mainly focused on change in HbA1c as outcome parameter.

In the first part of this thesis, longer-term effectiveness of FGM in persons with diabetes who started FGM was assessed. In persons who continued FGM use for two years, sustained improvement glycemic control and quality of life was observed. Commencement of FGM was also associated with improvement of mental well-being. A higher baseline HbA1c was correlated with a greater decline in HbA1c.

The second part of this thesis provides more insight into changes in glycemic parameters in persons with different levels of glycemic (dys)regulation. Initiation of FGM was associated with improvement of glycemic parameters, irrespective of pre-use regulation or treatment modality. A higher flash glucose monitoring scan rate was associated with improvement of glycemic control, e.g. time in glucose target range, time in hyperglycemia and glycemic variability.