{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T03:44:22Z","timestamp":1794368662625,"version":"4.9.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2019,11,15]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The FreeStyle Libre is a flash glucose monitoring (FSL-FGM) system. Compared with finger-prick based self-monitoring of blood glucose, FSL-FGM may provide benefits in terms of improved glycemic control and decreased disease burden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Prospective nationwide registry. Participants with diabetes mellitus (DM) used the FSL-FGM system for a period of 12 months. End points included changes in HbA1c, hypoglycemia, health-related quality of life (12-Item Short Form Health Survey<jats:sup>v2<\/jats:sup> (SF-12<jats:sup>v2<\/jats:sup>) and 3-level version of EuroQol 5D (EQ-5D-3L)), a specifically developed patient-reported outcome measures (PROMs) questionnaire, diabetes-related hospital admission rate and work absenteeism. Measurements were performed at baseline, and after 6 months and 12 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>1365 persons (55% male) were included. Mean age was 46 (16) years, 77% of participants had type 1\u2009DM, 16% type 2\u2009DM and 7% other forms. HbA1c decreased from 64 (95%CI 63 to 65) mmol\/mol to 60 (95%CI 60 to 61) mmol\/mol with a difference of \u22124 (95%\u2009CI \u22126 to 3)\u2009mmol\/mol. Persons with a baseline HbA1c &gt;70\u2009mmol\/mol had the most profound HbA1c decrease: \u22129 (95%\u2009CI \u221212 to to 5)\u2009mmol\/mol. EQ-5D tariff (0.03 (95%CI 0.01 to 0.05)), EQ-VAS (4.4 (95%CI 2.1 to 6.7)) and SF-12<jats:sup>v2<\/jats:sup> mental component score (3.3 (95%CI 2.1 to 4.4)) improved. For most, PROMs improved. Work absenteeism rate (\/6\u2009months) and diabetes-related hospital admission rate (\/year) decreased significantly, from 18.5% to 7.7% and 13.7% to 2.3%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Real world data demonstrate that use of FSL-FGM results in improved well-being and decreased disease burden, as well as improvement of glycemic control.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2019-000809","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T13:25:12Z","timestamp":1575897912000},"page":"e000809","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":137,"title":["Improved well-being and decreased disease burden after 1-year use of flash glucose monitoring (FLARE-NL4)"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4687-1157","authenticated-orcid":false,"given":"Marion","family":"Fokkert","sequence":"first","affiliation":[{"name":"Clinical Chemistry, Isala, Zwolle, Overijssel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireille","family":"Edens","sequence":"additional","affiliation":[{"name":"Department of Innovation and Science, Isala, Zwolle, Overijssel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eglantine","family":"Barents","sequence":"additional","affiliation":[{"name":"Dutch Diabetes Association, Leusden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Mollema","sequence":"additional","affiliation":[{"name":"General Practice, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert","family":"Slingerland","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, Isala, Zwolle, Overijssel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinold","family":"Gans","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk","family":"Bilo","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2025073112450521000_7.1.e000809.1","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/S0140-6736(98)07037-8","article-title":"Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)","volume":"352","year":"1998","journal-title":"The Lancet"},{"key":"2025073112450521000_7.1.e000809.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052187"},{"key":"2025073112450521000_7.1.e000809.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2016-000320","article-title":"Performance of the FreeStyle Libre flash glucose monitoring system in patients with type 1 and 2 diabetes mellitus","volume":"5","author":"Fokkert","year":"2017","journal-title":"BMJ Open Diab Res Care"},{"key":"2025073112450521000_7.1.e000809.4","unstructured":"Ministerie van Volksgezondheid W en S . Standpunt Flash Glucose Monitoring (FreeStyle Libre) bij diabetes - Standpunt - Zorginstituut Nederland [Internet], 2018. Available: https:\/\/www.zorginstituutnederland.nl\/publicaties\/standpunten\/2018\/04\/30\/standpunt-flash-glucose-monitoring-freestyle-libre-bij-diabetes [Accessed 19 Jun 2019]."},{"key":"2025073112450521000_7.1.e000809.5","unstructured":"ICHOM | Diabetes Standard Set | Measuring Outcomes [Internet] . ICHOM \u2013 International Consortium for health outcomes measurement. Available: https:\/\/www.ichom.org\/portfolio\/diabetes\/ [Accessed 19 Jun 2019]."},{"key":"2025073112450521000_7.1.e000809.6","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1002\/nur.21806","article-title":"Beware of the origin of numbers: standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations","volume":"40","author":"Hagell","year":"2017","journal-title":"Res Nurs Health"},{"key":"2025073112450521000_7.1.e000809.7","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-004-1214-z"},{"key":"2025073112450521000_7.1.e000809.8","unstructured":"Van Reenen M , Oppe M . EQ-5DL-3L user guide basic information on how to use the EQ-5D-3L instrument 2015."},{"key":"2025073112450521000_7.1.e000809.9","unstructured":"Lammers LM , Stalmeijer PFM , McDonnell J , et al . Kwaliteit van leven meten in economische evaluaties: Het Nederlands EQ-5D-tarief. Ned Tijdschr Geneeskd 2005:1574\u20138."},{"key":"2025073112450521000_7.1.e000809.10","doi-asserted-by":"crossref","DOI":"10.2337\/db19-99-LB","article-title":"99-LB: meta-analysis of three real-world, chart review studies to determine the effectiveness of FreeStyle Libre flash glucose monitoring system on HbA1c in adults with type 2 diabetes","volume":"68","author":"Kroeger","year":"2019","journal-title":"Diabetes"},{"key":"2025073112450521000_7.1.e000809.11","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1007\/s00125-019-4894-1","article-title":"Marked improvement in HbA\n                  1c\n                following commencement of flash glucose monitoring in people with type 1 diabetes","volume":"62","author":"Tyndall","year":"2019","journal-title":"Diabetologia"},{"key":"2025073112450521000_7.1.e000809.12","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1056\/NEJMp1813418","article-title":"Patient-Experience Data and Bias \u2014 What Ratings Don\u2019t Tell Us","volume":"380","author":"Poole","year":"2019","journal-title":"New England Journal of Medicine"},{"key":"2025073112450521000_7.1.e000809.13","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1553"},{"key":"2025073112450521000_7.1.e000809.14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/cod.13120","article-title":"Allergic contact dermatitis caused by medical devices for diabetes patients: a review","volume":"79","author":"Herman","year":"2018","journal-title":"Contact Dermatitis"}],"container-title":["BMJ Open Diabetes Research &amp; Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjdrc-2019-000809","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T19:45:13Z","timestamp":1753991113000},"score":1,"resource":{"primary":{"URL":"https:\/\/drc.bmj.com\/lookup\/doi\/10.1136\/bmjdrc-2019-000809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12,9]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bmjdrc-2019-000809"],"URL":"https:\/\/doi.org\/10.1136\/bmjdrc-2019-000809","relation":{},"ISSN":["2052-4897"],"issn-type":[{"value":"2052-4897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}