A global study from Otago shows that flash glucose monitors can help young people with type 1 diabetes monitor their blood glucose levels more effectively, but do not improve glycemic control.

A team of researchers co-led by Associate Professor Ben Wheeler and Dr. Sara Boucher from the Department of Women's and Children's Health at the University of Otago conducted a six-month trial on adolescents aged 13 to 20 years with poor glycemic control. Associate Professor Wheeler said, "We conducted a large-scale trial in this population for the first time; they may benefit most from new diabetes treatments, but are usually not included in diabetes studies."

The flash glucose monitoring system launched in New Zealand in 2017 allows users to wear a small sensor under the skin of the upper arm (replaced every 14 days) and scan the sensor using a separate handheld device.

When the reader is close to the sensor, the sensor transmits the current glucose level, along with an eight-hour retrospective glucose trend and predicted increases or decreases in glucose levels.

The research team compared the monitoring results of 64 study participants, dividing them into two groups: one using flash glucose monitoring and the other using finger-prick blood glucose monitoring.

Encouragingly, Associate Professor Wheeler stated that participants in the flash glucose monitoring study more than doubled the frequency of their blood glucose level monitoring.

At the start of the study period, both groups checked their levels on average less than twice a day, which is below the recommended minimum of four checks per day.

After six months, those using the flash monitor checked their levels an average of 3.8 times per day, including scans and finger pricks as needed, while the control group checked their blood glucose levels an average of 1.4 times per day.

Surprisingly, researchers found that the group using flash monitoring technology did not show significantly improved glycemic control or quality of life compared to the control group after six months.

Associate Professor Wheeler said that despite improved blood glucose checking technology and positive experiences reported by participants and families, a more in-depth approach is needed to improve psychosocial outcomes. "We also showed that to translate these positive aspects into healthier diabetes management, we need more—either more support or more automation technology to help deliver insulin, rather than just monitoring."

Dr. Sara Boucher said that traditionally, young people have the poorest glycemic control.

"To date, we have been working to find options that help improve this.

The purpose of this study is to observe whether using a flash glucose monitor instead of blood glucose monitoring can help youth with type 1 diabetes and unhealthy diabetes achieve healthier diabetes control within six months.

Next steps in the research include providing more support to young people, led by Dr. Boucher, with a focus on diet and sleep, while also aiming to increase automation, such as combining less invasive monitoring technologies with computer-driven automated insulin delivery systems like the artificial pancreas.

Background Information

There are 25 thousand people with diabetes in New Zealand, of whom an estimated 10% have type 1 diabetes.

It is usually diagnosed in childhood, and patients must constantly monitor blood glucose levels and inject insulin to sustain life, as their bodies have stopped naturally producing insulin.

However, due to the desire to fit in with peers, young people do not always monitor their blood glucose levels regularly, especially given the physical discomfort associated with the more commonly used finger-prick monitoring method, which requires up to 10 checks per day.

People using flash glucose monitors may still need to use the finger-prick method once or twice a week.