The role of Flash Glucose Monitoring System at annual review during the COVID-19 restrictions, within Cystic Fibrosis Diabetes Service at Blackpool Adult Cystic Fibrosis Centre, UK

ABSTRACT

Objectives: The gold standard of care for diagnosing Cystic Fibrosis-Related Diabetes (CFRD), as recommended by CF Trust and American Diabetes Association guidelines (Bridges et al., 2018), is to use the Oral Glucose Tolerance Test (OGTT). Flash Glucose Monitoring System (FGMS) was introduced for CF patients, shielding due to COVID-19, as part of their CF annual review (A/R) alongside chest status, weight and HbA1c. Methods: • A/R information sheet outlining reason for using FGMS and sharing data agreement via Libre View. • Video consultation with Dietitian/CF Diabetes Nurse to discuss and support insertion of Libre sensor and link to sharing data. • Patients completed 2 weeks of daily scanning and food diary. • 2 weekly CFRD MDT data analysis, using the Brompton CGM criteria for CFRD diagnosis (see table 1). [Table presented] Results: • Good uptake of CFRD screening process. • 13 patients screened with FGMS (see table 2). • Monitoring of glucose against timely food diary, using Libre View App. • FGMS has identified patients with impaired glucose handling that may have been missed on OGTT. • Patients able to observe effect of food on blood glucose levels. [Table presented] Conclusion: Using the FGMS has enhanced patient's compliance with A/R screening for CFRD. The FGMS has identified early diagnosis of patients with CFRD and patients with delayed insulin response leading to effective insulin treatment and appropriate dietary changes. Feedback to the patient following A/R has been quicker and more efficient due to video consultations and the sharing of glucose results and food diary via the App and Libre View sharing agreement. The role of FGMS at annual review allows closer analysis of glucose trends which otherwise would have been missed on the OGTT screening.