Capillary blood glucose monitoring has been fundamental throughout the history of diabetes to improve metabolic control and reduce complications. Among the various continuous glucose monitoring (CGM) systems, the most widely used is the “flash” system, which measures glucose continuously.

Continuous glucose monitoring throughout the day with this system can prevent periods of hypoglycemia and hyperglycemia, unlike the traditional system. This method not only alerts the patient to fluctuations in glucose levels, but also facilitates quick and efficient action through more precise administration of the required insulin. This system shows the trend of blood glucose levels and allows the patient to predict what their levels will be in the short term.

The Flash System consists of two main components: a handheld reader and a disposable sensor that is worn on the back of the arm. The reader is used to wirelessly scan the sensor and obtain glucose readings. When the patient scans the sensor with a special device or cell phone, the current and previous 8-hour blood glucose levels are provided. This allows the patient to take preventative measures against hyper- and hypoglycemia.

The only “flash” system on the market is the FreeStyle Libre (FSL), which is why it is widely used in developed countries and financed by most public health systems.

A study conducted at the University of Paris analyzed hospital admissions for hyperglycemia, severe hypoglycemia, ketoacidosis, and diabetes-related coma over a one-year period. Patients with type 1 (DM1) and type 2 (DM2) diabetes, treated with a “flash” system, participated and their evolution was compared with the previous year without continuous glucose monitoring. The sample included 74,011 individuals, 45% with DM1 and 55% with DM2. Of these, 88% were treated with multiple doses of insulin or an insulin pump. The use of the Flash system showed a dramatic reduction in hospital admissions for diabetic decompensation, namely 49.0% in people with DM1 and 39.4% in people with DM2. The most significant reductions were in admissions for ketoacidosis, which were more than halved (56.2% in DM1 and 52.1% in DM2), and for diabetes-related coma (39.6% in DM1 and 31.9% in DM2). Hospitalizations for hypoglycemia and hyperglycemia decreased by 10.8% and 26.5%, respectively, in people with DM2.

An interesting finding of the study related to capillary blood glucose monitoring was that hospitalizations for hypoglycemia were marginal, most likely due to the ability of patients to resolve them without the need for hospitalization.

The General Alliance of Patients (AGP) believes that:

• The new Flash Glucose Monitoring System breaks new ground in the management of patients with diabetes who are treated with multiple doses of insulin (MDIs).
• Obtaining glucose levels in a simple and painless way, without the daily finger prick, allows for more frequent monitoring. The patient has more information that is easy to interpret and use, which contributes to improved adherence and metabolic control.
• By having more data about their glycemic profile, patients will be able to better adjust the insulin doses needed to optimize their own metabolic control, thus avoiding acute complications in the short term and chronic complications in the long term.
• This device will provide patients with greater self-management of their disease and autonomy in decision making, which is a critical element in treatment adherence and a reduction in the burden of care by reducing the number of doctor’s visits and hospitalizations. This situation will lead to savings for the health system, both economically and in terms of human resources.
• The new Flash Glucose Monitoring System facilitates communication between professionals and patients with the common goal of optimizing metabolic control by sharing information and knowledge to improve decision making. This defines a new model focused on patient care, autonomy, and shared responsibility. It is important to emphasize the importance of involving all stakeholders in the system in order to achieve collaborative efficiency.
• Non-adherence reflects the difficulty of living with diabetes and is one of the main reasons for not achieving the desired goals. It also has a major negative impact on the natural history of DM and on costs.
• In patients treated with multiple insulin injections, the high number of daily injections is one of the main causes of non-compliance and optimization of metabolic control. Elimination of these habitual injections will undoubtedly have a positive influence on the psychological state of the patients.
• Personal empowerment is key for patients to be able to manage their DM on a daily basis with greater confidence in the control and optimization of their treatment. It is important to emphasize the importance of providing patients with resources that facilitate their daily decision making, as they are the active daily decision makers in the management of their disease. In this way, the patient will be able to better control his pathology by understanding and participating in his treatment in a much more positive and active way.
• This new Flash Glucose Monitoring System is a key technological innovation that will enable both professionals and patients to make the right decisions. Daily information is essential to know the pattern of glucose levels, their variability and to make the necessary therapeutic adjustments.

For all these reasons, a system that is integrated into the daily life of the diabetic patient, that provides easy-to-interpret data and, at the same time, eliminates the routine of finger pricking, allowing a better social adaptation of the diabetic patient, will undoubtedly become a fundamental element in improving the control of the disease and will help the patient to make appropriate decisions regarding his or her treatment.