335-OR: Flash Sensor-Based Glucose Monitoring Accompanied by Structured Education Is More Effective in Reducing HbA1c and Diabetes Distress
Authors: KULZER BERNHARD , PRIESTERROTH LILLI , HERMANNS NORBERT , HAAK THOMAS , EHRMANN DOMINIC 
Published: June 2019

Flash sensor-based glucose monitoring (FSGM) provides people with diabetes with an exhaustive overview about their glycemic control. However, the plethora of data can also be challenging and overwhelming. We developed a treatment and education program for FSGM-use (named FLASH) and evaluated its efficacy in a randomized controlled trial. We included people with diabetes on an intensified insulin therapy who either already used FSGM before the study (FSGM-experienced) or who newly used FSGM with the beginning of the study (FSGM-naïve). All participants were either randomized to receiving the FLASH education or to a treatment-as-usual control group. We report on results of ANCOVA with baseline-adjusted HbA1c and diabetes distress values at follow-up, respectively. A total of 199 participants were analyzed. FSGM-experienced participants were using FSGM for a mean duration of 7.9 ± 9.5 months before study start. At the six-month follow-up, FLASh led to a significant reduction in HbA1c (8.06% vs. 8.22%; p=0.033) and diabetes distress (1.16 vs. 1.00; p = 0.027). However, independent from the group allocation, FSGM-experienced participants (n=121) had significantly higher distress levels at follow-up than FSGM-naïve (n=78) participants (1.16 vs. 1.01; p = 0.032). FSGM-experienced users that never received education had a significantly higher distress level (1.26) than FSGM-experienced users that received education (1.06; p = 0.045), FSGM-naïve users with education (0.95; p = 0.003) and without education (1.06; p = 0.021). The FLASH education led to a reduction in distress. Previous FSGM-use without education was associated with the highest distress, whereas FSGM-naïve participants who received the FLASH education had the lowest distress levels. Thus, results indicate that FSGM-use accompanied with FLASH education is more beneficial than FSGM-use alone. In addition, FSGM-specific education should be employed better sooner than later.

Disclosure
B. Kulzer: Advisory Panel; Self; Ascensia Diabetes Care, Berlin-Chemie AG, Medtronic, Novo Nordisk Inc., Roche Diabetes Care. Research Support; Self; Abbott, Berlin-Chemie AG, Roche Diabetes Care. Speaker's Bureau; Self; Abbott, Ascensia Diabetes Care, Berlin-Chemie AG, Eli Lilly and Company, Novo Nordisk Inc., Roche Diabetes Care. L. Priesterroth: None. N. Hermanns: Advisory Panel; Self; Abbott. Board Member; Self; Eli Lilly and Company. Research Support; Self; Abbott, Berlin-Chemie AG, Dexcom, Inc., Roche Diabetes Care. Speaker's Bureau; Self; Berlin-Chemie AG, Dexcom, Inc., Novo Nordisk A/S. T. Haak: Advisory Panel; Self; Abbott, AstraZeneca, Merck Sharp & Dohme Corp., Roche Diabetes Care. Research Support; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH. Speaker's Bureau; Self; Abbott, AstraZeneca, Berlin-Chemie AG, Eli Lilly and Company, Novo Nordisk Inc. D. Ehrmann: Advisory Panel; Self; Medtronic. Speaker's Bureau; Self; Abbott, Berlin-Chemie AG, Dexcom, Inc.

Funding
Abbott Diabetes Care Germany