A comparison of FreeStyle Libre 2 to self-monitoring of blood glucose in children with type 1 diabetes and sub-optimal glycaemic control: a 12-week randomised controlled trial protocol

Sara Styles; Ben Wheeler; Alisa Boucsein; Hamish Crocket; Michel de Lange; Dana Signal; Esko Wiltshire; Vicki Cunningham; Anita Lala; Wayne Cutfield; Martin de Bock; Anna Serlachius; Craig Jefferies

doi:10.1007/s40200-021-00907-y

A comparison of FreeStyle Libre 2 to self-monitoring of blood glucose in children with type 1 diabetes and sub-optimal glycaemic control: a 12-week randomised controlled trial protocol

J Diabetes Metab Disord. 2021 Oct 5;20(2):2093-2101. doi: 10.1007/s40200-021-00907-y. eCollection 2021 Dec.

Authors

Sara Styles¹, Ben Wheeler^{2

3

4}, Alisa Boucsein², Hamish Crocket⁵, Michel de Lange⁶, Dana Signal^{7

8}, Esko Wiltshire^{9

10

4}, Vicki Cunningham¹¹, Anita Lala¹², Wayne Cutfield^{7

8}, Martin de Bock^{13

14}, Anna Serlachius¹⁵, Craig Jefferies^{7

8}

Affiliations

¹ Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
² Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
³ Paediatrics, Southern District Health Board, Dunedin, New Zealand.
⁴ Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
⁵ Health, Sport and Human Performance, School of Health, University of Waikato, Hamilton, New Zealand.
⁶ Centre for Biostatistics, Te Pokapū Tatauranga Koiora, Division of Health Sciences, Dunedin, New Zealand.
⁷ Paediatric Diabetes and Endocrinology, Starship Children's Health, Auckland, New Zealand.
⁸ Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁹ Department of Paediatrics and Child Health, University of Otago, Wellington, Wellington, New Zealand.
¹⁰ Capital & Coast District Health Board, Wellington, New Zealand.
¹¹ Northland District Health Board, Whangarei, New Zealand.
¹² Paediatrics, Bay of Plenty District Health Board, Tauranga, New Zealand.
¹³ Department of Paediatrics, University of Otago, Christchurch, New Zealand.
¹⁴ Canterbury District Health Board, Christchurch, New Zealand.
¹⁵ Psychological Medicine, The University of Auckland, Auckland, New Zealand.

Abstract

Purpose: Frequent glucose monitoring is necessary for optimal glycaemic control. Second-generation intermittently scanned glucose monitoring (isCGM) systems inform users of out-of-target glucose levels and may reduce monitoring burden. We aim to compare FreeStyle Libre 2 (Abbott Diabetes Care, Witney, U.K.) to self-monitoring of blood glucose in children with type 1 diabetes and sub-optimal glycaemic control.

Methods: This open-label randomised controlled trial will enrol 100 children (4-13 years inclusive, diagnosis of type 1 diabetes ≥ 6 months, HbA1c 58-110 mmol/mol [7.5-12.2%]), from 5 New Zealand diabetes centres. Following 2 weeks of blinded sensor wear, children will be randomised 1:1 to control or intervention arms. The intervention (duration 12 weeks) includes second-generation isCGM (FreeStyle Libre 2) and education on using interstitial glucose data to manage diabetes. The control group will continue self-monitoring blood glucose. The primary outcome is the difference in glycaemic control (measured as HbA1c) between groups at 12 weeks. Pre-specified secondary outcomes include change in glucose monitoring frequency, glycaemic control metrics and psychosocial outcomes at 12 weeks as well as isCGM acceptability.

Discussion: This research will investigate the effectiveness of the second-generation isCGM to promote recommended glycaemic control. The results of this trial may have important implications for including this new technology in the management of children with type 1 diabetes.

Trial registration: This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry on 19 February 2020 (ACTRN12620000190909p) and the World Health Organization International Clinical Trials Registry Platform (Universal Trial Number U1111-1237-0090).

Keywords: Children; FreeStyle Libre 2; Glycaemic control; Intermittently scanned continuous glucose monitoring; Self-monitoring of blood glucose; Type 1 diabetes.