Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester.
Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester.
Diabet Med. 2018 Apr;35(4):472-482. doi: 10.1111/dme.13584. Epub 2018 Feb 27.
The FreeStyle Libre flash glucose monitor became available on prescription (subject to local health authority approval) in all four nations of the UK from November 2017, a watershed moment in the history of diabetes care. Calibration free, the FreeStyle Libre is a disc worn on the arm for 14 days which is designed largely to replace the recommended 4-10 painful finger-stick blood glucose tests required each day for the self-management of diabetes. This review discusses clinical data from randomized and observational studies, considers device accuracy metrics and deliberates its popularity and the potential challenges that this new device brings to diabetes care in the UK. In randomized trials, FreeStyle Libre use is associated with a reduction in hypoglycaemia and, in observational studies, improvements in HbA levels. User satisfaction is high and adverse events are low. Accuracy of the FreeStyle Libre is comparable to currently available real-time continuous glucose monitors in adults, children and during pregnancy; the cost of the FreeStyle Libre is lower. Glucose data can be visualized in multiple devices and platforms, and summarized in an ambulatory glucose profile to aid pattern recognition and insulin dose adjustment. There is a need for appropriate education, of both users and healthcare professionals, to harness the full benefits. Further randomized studies to assess the long-term impact on HbA , particularly in those with high baseline HbA and in specific age groups, such as adolescents and young adults, are warranted. The potential impact on complications, is yet to be realized.
自 2017 年 11 月起，FreeStyle Libre 瞬感血糖监测仪在英国四个国家（地区）可凭处方（须经当地卫生主管部门批准）购买，这是糖尿病护理史上的一个重要里程碑。FreeStyle Libre 无需校准，它是一种可佩戴在手臂上 14 天的圆盘，主要用于替代糖尿病日常自我管理所需的、每天推荐的 4-10 次手指采血血糖检测。本文综述了随机对照研究和观察性研究的临床数据，考虑了设备准确性指标，并探讨了其在英国的普及情况以及该新型设备给糖尿病护理带来的潜在挑战。在随机试验中，使用 FreeStyle Libre 与低血糖的减少相关，而在观察性研究中，HbA1c 水平有所改善。用户满意度高，不良事件少。FreeStyle Libre 的准确性与成人、儿童和妊娠期现有实时连续血糖监测仪相当，且其成本更低。血糖数据可在多种设备和平台上可视化，并汇总在动态血糖图谱中，以辅助模式识别和胰岛素剂量调整。需要对用户和医护人员进行适当的教育，以充分利用其优势。需要进一步的随机研究来评估对 HbA1c 的长期影响，特别是在基线 HbA1c 较高的患者以及特定年龄组（如青少年和年轻成人）中。其对并发症的潜在影响还有待观察。
