P233 One year post-introduction of centrally-funded flash glucose monitoring in paediatric type 1 diabetes: a regional centre’s experience

Background The FreeStyleLibre Flash Glucose Monitoring system (FGMS) continuously measures glucose concentration in the interstitial fluid. It was approved under the Community Drug Scheme in Ireland from 1st April 2018; making this technology available to all children ≥4 years with type 1 diabetes using intensive insulin regimens. Aim To assess the effect of FGMS on glycaemic control and to explore engagement of patients with the technology; looking at frequency of self-monitoring and of uploads to the web-based clinic interface LibreView. Methods This was a single centre observational study. All patients receiving FGMS were identified. HbA1c at quarterly intervals from 3 months prior to 6 months post introduction of the FGMS were extracted. We assessed level of engagement by reviewing the frequency of data uploading to the LibreView system. We also quantified frequency of self-monitoring overtime via ‘flashes per day’. Results Of 215 active patients, 108 patients (50%) commenced using FGMS during the study; 58 (54%) male and 50 (46%) female. Thirty two (30%) were using continuous subcutaneous insulin infusion (CSII) and 76 (70%) injectable regimes .Mean age was 11.6±3.9 years (4.7–18.5 years). Mean duration of diabetes was 5.1±3.7 years. The mean HbA1c in the cohort improved across the study period from 8.0±1.1% at 3 months prior, to 7.7±0.9% at 6 months post-initiation. Technology engagement was assessed in 93 patients utilising the FGMS >1 month. Only 25 (26%) patients uploaded ≥1 within the first 3 months, and only 9 (17%) of eligible patients in the second 3 month period; the frequency of uploading was hugely variable. Mean flashes per day was 9.9 (0–29) in the first and 9.7(0–38) in the second 3 month period. Conclusion Improvement was demonstrated in the mean HbA1c overtime, in keeping with the limited available evidence in other paediatric cohorts (1). Low rates of engagement with uploading data were observed, with decreasing engagement over time. This is a potential area to target improvement as having an ambulatory glucose profile to review remotely could aid in pattern recognition and insulin dose adjustment, thus impacting glycaemic control. Having improved engagement with the LibreView would also allow analysis of time in target range and glucose variability, which are recognised as important targets for users of continuous glucose monitoring systems. Reference Campbell FM, Murphy NP, Stewart C, Biester T, Kordonouri O. Outcomes of using flash glucose monitoring technology children young people with type 1 diabetes arm study. Pediatr Diabetes