# Improvement in Glycemic Metrics With the First and Second Continuous Glucose Monitoring (CGM) Sensor Use in Indian Patients With Type 2 Diabetes Mellitus

## TL;DR

This study shows that using a glucose monitoring device improves glycemic control in Indian patients with type 2 diabetes.

## Contribution

The study evaluates the effectiveness of Abbott FreeStyle Libre in an Indian population with type 2 diabetes.

## Key findings

- TIR negatively correlates with lower HbA1c, average glucose, and TAR, and positively with TBR.
- TAR, TBR, and HbA1c are significant predictors of TIR.
- CGM use is associated with better glycemic control in Indian T2DM patients.

## Abstract

Background: Continuous glucose monitoring (CGM) provides the real-time monitoring of glycemic fluctuations. Better control of hemoglobin A1C (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) using Abbott FreeStyle Libre (Chicago, Illinois, United States) was reported. This study evaluated the glycemic outcomes in T2DM patients using Abbott FreeStyle Libre in Indian settings.

Methods: In this single-center retrospective study, data was collected from T2DM patients aged ≥18 years prescribed with Abbott FreeStyle Libre at Gupta Ultrasound and Heart Care Centre, New Delhi, India. The first application was considered the first use of FreeStyle Libre. The measurements were obtained from a sensor that operated continuously for as long as 14 days. The second application meant patients were using FreeStyle Libre for the second time continuously for 14 days following a break of two weeks after the first application. Time-in-range (TIR) is the percentage of time that a person spends with their blood glucose levels in a recommended target range. Time-below-range (TBR) is the time spent with blood sugar lower than the recommended range. Time-above-range (TAR) is the time spent above the recommended range. Relationship between TIR and various demographics/CGM metrics were analyzed.

Results: Overall, 649 and 60 patients were included from the first application and the second application, respectively. The average duration of DM was 10-15 years in most patients, with hypertension being the predominant comorbidity. TIR negatively correlated with lower HbA1c (r=−0.547; p<0.001), lower average glucose (r=−0.790; p<0.001), and TAR (r=−0.951; p<0.001) and positively correlated with TBR (r=0.190; p<0.001). TAR, TBR, and HbA1c were identified as significant predictors of TIR.

Conclusion: TIR from FreeStyle Libre showed a meaningful association with glycemic control, which could aid in optimizing treatment plans and improving clinical outcomes of T2DM patients.