Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2021; 12(11): 1908-1916
Published online Nov 15, 2021. doi: 10.4239/wjd.v12.i11.1908
Factors influencing the effectiveness of using flash glucose monitoring on glycemic control for type 1 diabetes in Saudi Arabia
Hala Ibrahim Alhodaib, Sama Alsulihem
Hala Ibrahim Alhodaib, Community Health Sciences Department, King Saud University, Riyadh 11564, Saudi Arabia
Sama Alsulihem, College of Medicine, King Saud University, Riyadh 11564, Saudi Arabia
Author contributions: Alsulihem S collected the patients’ clinical data; Alhodaib H wrote the manuscript; all authors conceived and designed the study and analyzed the data.
Institutional review board statement: The Institutional Review Board of King Saud University provided approval for this study, No. 19/0812/IRB.
Informed consent statement: No individual informed consent forms have been signed by participants as this study was a retrospective study, so it was not applicable.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: The datasets extracted and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hala Ibrahim Alhodaib, PhD, Assistant Professor, Community Health Sciences Department, King Saud University, Prince Turki Bin Abdulaziz Alawwal Street, Riyadh 11564, Saudi Arabia.
Received: May 31, 2021
Peer-review started: May 31, 2021
First decision: July 3, 2021
Revised: July 14, 2021
Accepted: September 15, 2021
Article in press: September 15, 2021
Published online: November 15, 2021
Research background

Type 1 diabetes (T1D) affects a large number of children and adolescents in Saudi Arabia, and as a result flash glucose monitoring (FGM) devices are widely used. The factors influencing the effectiveness of FGM are poorly understood in people with T1D.

Research motivation

FGM is more expensive than standard treatment, and there is no guideline for which patients should receive FGM or when they should start FGM. Each hospital in Saudi Arabia has different requirements for starting a diabetic patient on FGM. The effectiveness of FGM can be influenced by many factors, including age, body mass index, type of insulin treatment, duration of diabetes, duration of using FGM, and level of patient engagement.

Research objectives

We investigated the association between glycated hemoglobin (HbA1c) levels after using FGM and potential predictor factors in a population with T1D. The ultimate goal was to help develop national guidelines for those who are eligible to receive funding for FGM, which in turn will enhance the utilization of the device and manage hospital resources, resulting in improved outcomes.

Research methods

In this retrospective cohort study of 195 T1D patients aged 15 years and above who had used FGM for at least 1 mo, demographic and clinical parameters and related data were extracted from patient records at two hospitals.

Research results

FGM in this study resulted in a clinically significant reduction in HbA1c (-0.6 ± 2.1). The uncontrolled group (baseline HbA1c > 9) had the largest reduction in HbA1c levels. There was a statistically significant moderate and negative association between age and level of engagement and HbA1c levels. Patients in the age group of 18-years-old to 45-years-old with a high level of engagement were more likely to demonstrate a large reduction in HbA1c levels. The relationships between HbA1c and other factors varied between no association to weak association.

Research conclusions

FGM is a more effective technology for T1D patients over the age of 18 years who are committed to checking their glucose level at least six times a day.

Research perspectives

To identify the relationships between HbA1c levels and predictor factors on the long-term use of FGM, a multicenter, prospective, large-scale study on patients with T1D should be conducted in the future.