Glucose Awareness to Motivate and Enable Solutions (GAMES) in diabetes mellitus using flash glucose monitoring: A clinical programme

Aims This real‐world observational clinical programme evaluated short and medium‐term effects of intermittent flash glucose monitoring on HbA1c, glycaemic variability and lifestyle behavioural changes. Methods Two first‐generation Libre flash glucose monitoring sensors were provided 3–4 months apart with a food, activity diary, user evaluation survey and treatment modification after each sensor wear. T‐tests were used to compare glucose variables within each sensor (week 1 vs. week 2) and between sensors (1st sensor vs. 2nd sensor). EasyGV software was used to calculate glycaemic variability. Results From 42 type 1 diabetes and 120 type 2 diabetes participants, there was no statistically significant change in mean HbA1c for participants with type 1 diabetes at 3–4 months after the 1st sensor but there was a statistically significant HbA1c reduction for participants with type 2 diabetes [−4 mmol/mol (−0.4%), p = 0.008], despite no statistically significant differences in carbohydrate intake, exercise frequency and duration. Greater reduction was seen in those with baseline HbA1c> 86 mmol/mol (10%) in both type 1 [−12 mmol/mol (−1.1%), p = 0.009] and type 2 diabetes [−11 mmol/mol (−1.0%), p = 0.001). Both type 1 and type 2 diabetes showed improvements in Glucose Management Indicator and percentage time‐above‐range when comparing week 1 versus week 2 of the same sensor. Higher scan frequency resulted in improved glycaemic parameters and certain measures of glycaemic variability. The majority of participants (85%) agreed that flash glucose monitoring is a useful device but only 60% were keen to use it for daily monitoring. Conclusion Constant feedback from flash glucose monitoring improves glycaemic parameters within the first week of wear. Intermittent use 3–4 months apart resulted in greater improvements for those with higher baseline HbA1c.