ADA: Abbott's real-world data show FreeStyle Libre lowered A1c in Type 2 diabetes, with or without insulin

Real-world data showed the use of a continuous glucose monitoring system was able to substantially reduce A1c levels among people with Type 2 diabetes regardless of whether they were taking insulin.

The observational study of Abbott’s FreeStyle Libre system, presented at the annual scientific sessions of the American Diabetes Association (ADA), pointed to an 0.8 percentage-point drop—from 8.5% to 7.7%—in overall A1c levels after six months of use. After one year, that drop came to 0.6 percentage points.

According to Abbott, these results are similar to measurements seen in some clinical studies when insulin is added to a person’s regimen for the first time—suggesting that the information provided by a real-time glucose monitor could be effective in managing blood sugar compared to a drug treatment, the company said.

In addition, the greatest decreases in A1c were seen among non-insulin users, with a 0.9 percentage-point reduction after six months and 0.7 after one year. Among those on long-acting insulin, the reductions were 0.6 and 0.5 after six months and one year, respectively. 

"These data highlight how use of Abbott's continuous glucose monitor could be game-changing for people beyond intensive insulin users, translating to broader use of the technology to benefit all those living with diabetes, no matter where they are in the spectrum of care," said one of the study’s lead investigators, Eden Miller, a family practice physician at High Lakes Health Care.

The data also complement a study presented at last year’s ADA meeting, where Abbott showed its FreeStyle Libre system could help reduce A1c among people with Type 2 diabetes taking multiple insulin injections per day. 

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At the same time, Abbott presented a separate study this year showing its FreeStyle Libre system helped nearly cut in half the number of hospitalizations related to diabetic ketoacidosis—including by 52% among people with Type 1 diabetes and 47% in Type 2 diabetes. 

Researchers pulled healthcare claims data from a French national database spanning more than 33,000 FreeStyle Libre users with Type 1 diabetes and nearly 41,000 with Type 2 diabetes and analyzed the rates of ketoacidosis events in the years before and after they began using the monitor.  

The study showed fewer trips to the hospital among people who had previously been measuring their blood sugar up to five times a day using test strips as well as in those who were not performing any self-monitoring.

“The positive results of this study demonstrate that intermittently scanned continuous glucose monitoring may have significant implications for patient-centered clinical care and, given the increased burden of ketoacidosis on healthcare utilization and expenditure, it may have a positive impact on long-term economic health outcomes,” said the study’s lead author, Ronan Roussel, chief of the endocrinology, diabetes and nutrition department at Bichat-Claude Bernard Hospital in Paris.

An additional abstract showed the system's use was associated with a 30% reduction in acute diabetes events and complications among people with Type 2 diabetes who were not taking bolus insulin as well as a 13% drop in all-cause hospitalizations.

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And during the ADA meeting, Abbott received clearance from the FDA for its next-generation FreeStyle Libre 2 system in adults and children as young as 4. 

The self-applied sensor lasts for 14 days, measuring glucose levels every minute. Designed for people with Type 1 or Type 2 diabetes, the device is designed to work with the user’s choice of other diabetes devices. It can provide real-time alarms for high and low blood sugar levels, and use Bluetooth to alert the user without them having to scan the sensor. 

Abbott said it plans to offer the new system at the same price as the currently available FreeStyle Libre 14-day system, first cleared by the FDA in 2018.

Editor’s note: This story has been updated to include the recent clearance of the FreeStyle Libre 2 system.