Intermittent Use of Flash Glucose Monitoring as a Useful Tool for Patients with Type 1 Diabetes in Developing Countries

Abstract

Abstract Background and Aims: The cost of flash glucose monitoring (FGM) has been the principal barrier to treating type 1 diabetes (T1D) in developing nations; this study evaluates the efficiency of an intermittent scanning regimen on improving glycemic outcomes and preventing acute diabetic complications. Subjects and Methods: A total of 90 participants with a history of T1D over 2-year duration were randomized into three equal subgroups: Group I utilized self-monitoring of blood glucose (SMBG) only for 90 days, Group II used FGM replaced every 14 days, and Group III alternated between FGM for 2 weeks and SMBG for 4 weeks, followed by another 2 weeks of FGM and 4 weeks of SMBG. Comparison of baseline and 3-month glycated hemoglobin (HbA1c) values was made. In addition, we monitored patients for episodes of diabetic ketoacidosis (DKA), severe hypoglycemia, and nocturnal hypoglycemia. Furthermore, we evaluated time in range (TIR) between Groups II and III. Results: Group 1 revealed significantly elevated HbA1c compared with Groups II and III. There were three DKA episodes in Group I and none in Groups II and III. The TIR was found to be considerably higher in Group II than in Group III. Regarding severe hypoglycemia, the number of affected patients was 12 (Group I), 0 (Group II), and 3 (Group III). Conclusions: The use of intermittent FGM represents a viable, cost-effective strategy for patients unable to afford continuous FGM. This regimen effectively improves glycemic control (evidenced by reduced HbA1c and complications) and offers substantial protection against acute diabetic complications compared to SMBG alone.