FRONTIER : FReeStyle Libre system use in Ontario among people with diabetes in the IC / ES database—Evidence from real‐world practice: Patients on basal insulin, glucagon‐like peptide 1 receptor agonist or oral therapies

Mar 21, 2025Diabetes, obesity & metabolism

Use of the FreeStyle Libre glucose monitor in Ontario people with diabetes on basal insulin, GLP-1 drugs, or oral treatments

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Abstract

Mean HbA1c levels were statistically significantly reduced by 0.3-0.8% after the adoption of FreeStyle Libre glucose monitoring systems.

HbA1c levels improved in all four treatment groups among individuals aged ≤65 and >65 years.
Emergency department visits and hospitalization rates were significantly reduced after FreeStyle Libre acquisition in some treatment subgroups.
The most notable reductions in healthcare resource utilization were observed in the oral therapy only group and certain basal insulin subgroups.
Statistical significance was noted for reduced emergency department visits in individuals aged ≤65 years using basal insulin with GLP-1 RA therapy.

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AIM: We aimed to investigate glycated haemoglobin (HbA1c) levels and healthcare resource utilization (HCRU; emergency department [ED] visits or hospitalization) before and after adoption of FreeStyle Libre sensor-based glucose monitoring systems (FSL) by people with type 2 diabetes mellitus (T2DM) on basal insulin without glucagon-like peptide 1 receptor agonist (GLP-1 RA) therapy, basal insulin with GLP-1 RA therapy, GLP-1 RA therapy without insulin or oral therapy alone.

MATERIALS AND METHODS: Routinely collected administrative health data (housed at IC/ES, formerly the Institute for Clinical Evaluative Sciences) in Ontario, Canada were used to identify 20 253 people with T2DM who had a first FSL claim between 16 September 2019 and 31 August 2020 (index date) and remained active on FSL for 24 months' follow-up. HCRU was measured for 12 months before the index date and the last 12 months of the 24-month follow-up period. HbA1c data were taken from the latest tests in each period.

RESULTS: Mean HbA1c was statistically significantly reduced after FSL acquisition among people aged ≤65 or >65 years in all four treatment groups (range, 0.3-0.8% reduction). After FSL acquisition, ED visits and hospitalization were statistically significantly reduced in the oral therapy only group and in some basal insulin subgroups (without GLP-1 RA, all except hospitalization aged ≤65 years; with GLP-1 RA, only ED visits aged ≤65 years).

CONCLUSIONS: Among people with T2DM using basal insulin and/or non-insulin therapies, HbA1c levels were statistically significantly improved and HCRU was reduced after initiation of FSL.

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FRONTIER : FReeStyle Libre system use in Ontario among people with diabetes in the IC / ES database—Evidence from real‐world practice: Patients on basal insulin, glucagon‐like peptide 1 receptor agonist or oral therapies

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