Can flash glucose monitoring improve glucose management for Aboriginal and Torres Strait Islander peoples with type 2 diabetes? A protocol for a randomised controlled trial

• Published in: Trials
• Main Authors: Mariam Hachem, Tracey Hearn, Ray Kelly, Audrey Eer, Belinda Moore, Christine Sommerville, Sharon Atkinson-Briggs, Stephen Twigg, Meagan Freund, David O’Neal, David Story, Alex Brown, Anna McLean, Ashim Sinha, John Furler, Richard O’Brien, An Tran-Duy, Philip Clarke, Sabine Braat, Digsu N. Koye, Sandra Eades, Luke Burchill, Elif Ekinci
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2024
• Subjects: Type 2 diabetes; Aboriginal and torres Strait Islander peoples; Indigenous Australians; First Nations; Continuous glucose monitoring; Flash Glucose Monitoring; Medicine (General); R5-920
• Online Access: https://doi.org/10.1186/s13063-024-08267-7; https://doaj.org/article/a07c71fc823c4b6dbbc2d1d6272f85b7

Abstract Background Aboriginal and Torres Strait Islander peoples are disproportionately impacted by type 2 diabetes. Continuous glucose monitoring (CGM) technology (such as Abbott Freestyle Libre 2, previously referred to as Flash Glucose Monitoring) offers real-time glucose monitoring that is convenient and easy to use compared to self-monitoring of blood glucose (SMBG). However, this technology’s use is neither widespread nor subsidised for Aboriginal and Torres Strait Islander peoples with type 2 diabetes. Building on existing collaborations with a national network of Aboriginal and Torres Strait Islander communities, this randomised controlled trial aims to assess the effect of CGM compared to SMBG on (i) haemoglobin A1c (HbA1c), (ii) achieving blood glucose targets, (iii) reducing hypoglycaemic episodes and (iv) cost-effective healthcare in an Aboriginal and Torres Strait Islander people health setting. Methods This is a non-masked, parallel-group, two-arm, individually randomised, controlled trial (ACTRN12621000753853). Aboriginal and Torres Strait Islander adults with type 2 diabetes on injectable therapy and HbA1c ≥ 7.5% (n = 350) will be randomised (1:1) to CGM or SMBG for 6 months. The primary outcome is change in HbA1c level from baseline to 6 months. Secondary outcomes include (i) CGM-derived metrics, (ii) frequency of hypoglycaemic episodes, (iii) health-related quality of life and (iv) incremental cost per quality-adjusted life year gained associated with the CGM compared to SMBG. Clinical trial sites include Aboriginal Community Controlled Organisations, Aboriginal Medical Services, primary care centres and tertiary hospitals across urban, rural, regional and remote Australia. Discussion The trial will assess the effect of CGM compared to SMBG on HbA1c for Aboriginal and Torres Strait Islander people with type 2 diabetes in Australia. This trial could have long-term benefits in improving diabetes management and providing evidence for funding of CGM in this population. Trial registration ...