Researchers revolutionise type 1 diabetes management with flash glucose technology

Thanks to the ground-breaking research led by Hull York Medical School, people with type 1 diabetes now have a medical device available to them through the NHS to manage their condition effectively.

“It has been life changing. I feel in control of my diabetes for the first time. The device allows me to link my glucose levels to the food I am eating and my activity levels.”

This heartfelt testimonial is a patient who took part in research at Hull York Medical School which has transformed the management of their type 1 diabetes.

Thanks to the groundbreaking research led by Professor Thozhukat Sathyapalan and Dr Harshal Deshmukh, people with type 1 diabetes now have a medical device available to them through the NHS to manage their condition effectively.

Professor Thozhukat Sathyapalan and Dr Harshal Deshmukh, whose research has paved the way to patients with type 1 diabetes having access to the Freestyle Libre
Professor Thozhukat Sathyapalan and Dr Harshal Deshmukh, whose research has paved the way to patients with type 1 diabetes having access to the Freestyle Libre

Through several studies conducted by the researchers, their findings have paved the way for a transformative shift in the lives of individuals living with type 1 diabetes. Their research, centred around using the Freestyle Libre glucose monitoring system, has not only improved diabetes management but has also empowered patients to take control of their health like never before.

A flash glucose monitor uses a sensor that is placed on the back of the upper arm and worn externally by the user, allowing glucose information to be monitored using a mobile app.

Professor Sathyapalan and Dr Deshmukh, from the Clinical Sciences Centre at Hull York Medical School and leading experts in diabetes care at Hull University Teaching Hospitals NHS Trust, have long been dedicated to finding innovative solutions to enhance the lives of those living with diabetes.

Their research, spanning several years, has focused on the implementation of the Freestyle Libre system and its impact on diabetes management.

Through a wealth of published papers and real-world evidence, their research has supported the revision of NICE guidelines, ensuring that now anyone with type 1 diabetes can access this life-changing technology without any barriers or eligibility criteria.

Their invaluable contributions have paved the way for a transformative shift in diabetes management practices across the UK and on the quality of life of those living with type 1 diabetes.

Long-term impact: Freestyle Libre transforms type 1 diabetes management

The researchers have observed sustained results from the use of Freestyle Libre in managing diabetes. They have gathered data over a period of three years, revealing that individuals who have worn the device consistently experience continuous improvement in glycaemic control (Diabetic Medicine, June 2023).

This long-term data demonstrates the enduring effectiveness of the Freestyle Libre in supporting individuals with diabetes and enhancing their ability to manage their condition effectively.

Other studies by the researchers have found that use of the Freestyle Libre has led to:

Improvement in hypoglycaemia unawareness and severe hypoglycaemia (Diabetes, Obesity and Metabolism, January 2023)
Improvement in Time-in-Range (a new matrix for monitoring blood sugar levels) which leads to improvements in all aspects of diabetes (Diabetes Medicine, November 2022)
Improvement in diabetes outcomes irrespective of whether patients have diabetes education (The British Journal of Diabetes, December 2021)

Dr Deshmukh said, “We have data for three years now. We have shown in people that who have worn the device for three years, their glycaemic control continues to improve over the three years.”

"The Freestyle Libre has completely changed the management of type 1 diabetes"
Dr Harshal Deshmukh

Professor Sathyapalan continued, “We also showed that using the Freestyle Libre is very effective in people with very high blood sugar; It can actually have a significant reduction in those people.

"The worse the diabetes control, the more it will work. It gives people the confidence to manage their diabetes better.”

Financial and resource benefits of glucose management for the NHS

In addition to improving patient outcomes, another study by Dr Deshmukh and Professor Sathyapalan shows a reduction in hospital admissions related to diabetes complications (BMJ Open Diabetes Research and Care, March 2022).

The ability to manage glucose levels effectively has resulted in fewer emergency visits, highlighting the potential of the Freestyle Libre to alleviate the burden on healthcare systems and improve overall healthcare costs.

Dr Deshmukh explained, “Because people have much more control of their diabetes with the Freestyle Libre, it has a knock-on effect of costs savings for the NHS.

"We have seen a reduction in hospital admissions because people are less likely to have hypoglycaemia, or hyperglycaemia and ketoacidosis.”

How Freestyle Libre reduces diabetes related distress

The researchers were highly motivated to address diabetes-related distress, something they recognised within their own clinical practice.

Dr Deshmukh said, “Type 1 diabetes is very stressful situation for any patient. People have to check their blood sugar every day, 8 to 10 times a day.

"Imagine having to prick your fingers that many times a day, or worrying about managing medication or the risk of complications, the need for lifestyle adjustments, or the potential impact on relationships and overall wellbeing. This can cause diabetes related distress.”

They found that use of the Freestyle Libre led to a reduction in diabetes related distress (Diabetes, Obesity and Metabolism, October 2021).

Distress is not necessarily only confined to the person with type 1 diabetes; one of the key concerns addressed by the study was the fear of nocturnal hypoglycaemia, which often caused anxiety and sleep disturbances for both patients and their caregivers.

By allowing easy glucose monitoring during sleep, the Freestyle Libre proved particularly beneficial for parents of young children with diabetes, enabling them to monitor their glucose levels without waking them up.

Advocating for global impact

The impact of this research extends beyond the clinic, as Dr Deshmukh and Professor Sathyapalan actively share their findings on the benefits of the Freestyle Libre to the international medical community.

Their advocacy efforts aim to raise awareness and drive policy changes to ensure wider accessibility to this life-changing technology.

They have presented their research at numerous prestigious conferences and symposiums, delivering keynote speeches, and participating in panel discussions, including: the Diabetes UK Professional Conference, the American Diabetes Association, the Endocrine Society, the International Diabetes Federation, and the Association of British Clinical Diabetologists.

Dr Deshmukh was also awarded Rising Star at the latter conference in 2023, which is awarded to early career researchers who have made a substantial contribution to diabetes research and clinical practice.

By sharing their insights and data, they have sparked conversations and collaborations among healthcare professionals from around the world.

Reaching hard-to-reach communities

The researchers are keen that everyone benefits from this technology, regardless of their background.

Their previous research has found that there are ethnic disparities in people accessing the Freestyle Libre, they have higher diabetes distress, and also have less control of their blood sugar levels (Diabetic Medicine, March 2023).

To address this, the researchers are recruiting participants from hard-to-reach communities, including Afro-Caribbean and Asian backgrounds, aiming to address disparities in access to the technology.

They hope their findings will shed light on how to improve uptake in the Freestyle Libre in these populations.

Researcher showing a patient how to use the monitor for the Freestyle Libre

Exploring type 2 diabetes

The researchers now plan to expand their investigations to include type 2 diabetes, gestational diabetes, and individuals undergoing dialysis.

With approximately 90% of diagnoses are of type 2 diabetes, they hope to provide evidence for broader adoption of the Freestyle Libre in managing this condition.

"We are now looking at whether people with type 2 diabetes would benefit from using the Freestyle Libre"
Professor Thozhukat Sathyapalan

The diabetes research team are based at Hull Royal Infirmary, part of the Hull University Teaching Hospitals NHS Trust
The diabetes research team are based at Hull Royal Infirmary, part of the Hull University Teaching Hospitals NHS Trust

Professor Sathyapalan said, “Currently, patients with type 2 diabetes are not eligible to receive a Freestyle Libre, but having access to this technology could revolutionise clinical practice.”

The team's efforts have already generated significant interest and positive feedback from patients, who appreciate the device's ease of use and its potential to improve diabetes management.