Adapted from Miriam E. Tucker Medscape 3 Nov 2020
The Freestyle Libre is now the most popular continuous blood sugar monitoring device used in the UK. Clinicians want both patients and doctors to move away from simple discussions about the HbA1C and embrace the next best metric to determine potential complication rate which is TIME IN RANGE.
Dr Emma Wilmot of the Royal Derby Hospital wrote about this new guidance in Time in Range: a best practice guide for UK diabetes healthcare professionals in the context of the COVID-19 global pandemic published Oct 19 2020.
The paper reviews and provides the rationale for international guidelines which recommend that more than 70% of a persons glucose readings should fall between 3.9 and 10 mmol/L with modifications for children, older adults and pregnant women.
Freestyle Libre users have been found to experience significant improvements in their HbA1c, have fewer hospital admissions, and lower levels of diabetes related distress in patients with type one diabetes.
They suggest that discussion about the information retrieved from the Freestyle Libre can be particularly useful now that face to face consulting at clinics has largely been replaced by telephone and video calls. Both the Freestyle Libre and the Clarity for Dexcom provide time in range and HbA1C estimates.
One UK doctor, Professor Choudhary has seen none of his 1300 patients who use the Freestyle Libre at his clinic since March and has found the device indispensible. He says, ” It is important for doctors and patients to be speaking the same language. Otherwise consultations are ineffective. Time in range is the new language”.
DTN’s education page has videos about the devices that monitor time in range and more will be posted in the next few months.