Efficacy of flash glucose monitoring on HbA1c in type 2 diabetes: An individual patient data meta-analysis of real-world evidence

Aims: There is a growing body of evidence demonstrating the benefit of flash glucose monitoring in type 2 diabetes mellitus (T2DM). This individual patient data meta-analysis aimed to investigate the impact of commencing flash glucose monitoring on HbA1c in people living with T2DM treated with insulin in a real-world setting. Methods: A meta-analysis of eight observational studies which assessed change in HbA1c at 3-6 months following initiating flash glucose monitoring for which Abbott Diabetes Care could provide individual patient data was performed. Studies included adults with T2DM managed with insulin and baseline HbA1c between 8.0 %-12.0 % (64-108 mmol/mol). A one-stage model was created to explore heterogeneity. Results: A total of 803 patients were included in the analysis (mean(SD) age: 62.8(11.4) years, BMI: 32.2(6.8) kg/ m2, baseline HbA1c 9.0(0.9) % [75 (10) mmol/mol]). Commencement of flash glucose monitoring was associated with an HbA1c reduction of 0.89% (95% CI 0.71 to 1.08) (9.8 mmol/mol (95% CI 7.8 to 11.8)) at 3-6 months. In the one stage model, age, BMI and baseline HbA1c accounted for the substantial heterogeneity observed between studies. Conclusions: Commencement of flash glucose monitoring was associated with a significant reduction in HbA1c at 3-6 months in a real-world setting in T2DM managed with insulin.