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Diabetes Care publishes ABCD Freestyle Libre Audit outcomes

The use of FreeStyle Libre by people with Type 1 Diabetes in the UK is associated with significantly improved glycaemic control and Hypoglycaemic awareness as well as reduced Diabetes distress and few hospital admissions

According to the latest real-world results of the Association of British Clinical Diabetologists (ABCD) audit of the FreeStyle Libre system, people with type 1 diabetes who use the FreeStyle Libre system show significant improvements in glycaemic control, haemoglobin AIc (HbA1c) levels and awareness of hypoglycaemia. They are also much less likely to utilise healthcare resources as a result of improved management of their diabetes. The findings are published this week in the latest issue of Diabetes Care.1

The authors looked at data from over 10,000 FreeStyle Libre users from 101 NHS hospitals in the UK. To date, there had been no comprehensive, real-world, large population-based data sets looking at the impact of FreeStyle Libre on multiple aspects of diabetes care.

In this study, data from the nationwide audit for the FreeStyle Libre system were analysed to assess the patterns of use of FreeStyle Libre and to study its effect on glycaemic control, hypoglycaemia, diabetes-related distress, and hospital admissions due to hypoglycaemia and hyperglycaemia / diabetic ketoacidosis (DKA). Baseline data were available for a total of 10,370 FreeStyle Libre users.

For those patients with over seven months of follow-up data, the following outcomes were observed:

  • A significant reduction in HbA1c from 67.5 mmol/mol (8.3%) to 62.3 mmol/mol (7.9%) (data for 3,182 people with diabetes- with an even greater reduction in those who had high HbA1c levels before they started using FreeStyle Libre. In addition, the more people engaged with the management of their diabetes, by using the technology and scanning more frequently, the greater the HbA1c reduction.
  • A significant improvement in patient’s awareness of impending hypoglycaemia measured by the Gold score (data for 2,801 patients). Over half of people (53%) with impaired hypoglycaemia awareness at the start of the audit had regained awareness at follow-up.
  • A reduction in patient reported hypoglycaemic events: 85% said that they were able to reduce the frequency of hypoglycaemia; 80% stated that they were able to reduce the amount of time in hypoglycaemia; and 75% reported a reduction in nocturnal hypoglycaemia.
  • A reduction in diabetes distress – feeling overwhelmed by the demands of living with diabetes and/or a feeling of failing with their diabetes routine (data for 2,532 people with diabetes).
  • A significant reduction in paramedic callouts and hospital admissions due to hypoglycaemia and hyperglycaemia / diabetic ketoacidosis (DKA) at seven and a half months follow-up, compared to 12 months before FreeStyle Libre use (data for over 1,900 people with diabetes).

Commenting on the study’s findings, Dr Harshal Deshmukh said: “In our analysis of the largest real-world data set observing FreeStyle Libre use in type 1 diabetes, we show that its use is associated with significant improvements in glycaemic control, hypoglycaemia awareness,  severe hypoglycaemia, and a reduction in hospital admissions. Along with reduction in HbA1c, FreeStyle Libre use also reduces the variation in HbA1c levels which, if sustained, could lead to fewer complications. This population-based study of FreeStyle Libre continues to inform clinical practice and policy.”

Professor Sathyapalan said: ‘These results apply to those patients with type 1 diabetes, whose diabetes is poorly controlled or those who suffer from complications such as frequent hypoglycaemia or fear of hypoglycaemia. They demonstrate that the use of the Freestyle Libre system can significantly improve the experiences of those living with type 1 diabetes, increasing awareness and understanding, aiding self- management of the condition and reducing pressure on the NHS in terms of the ongoing management and treatment of patients with diabetes.’

The FreeStyle Libre system was made available on the NHS in 2017 to people with type 1 diabetes, who use insulin. The advantages of the FreeStyle Libre flash glucose monitoring system compared with continuous glucose monitoring systems include lower costs, factory calibration which removes the need for frequent painful finger pricks to calibrate and the sensor can be worn for 14 days.


  1. Deshmukh H et al (2020). Diabetes Care;


  1. Notes to editors

About the FreeStyle Libre System

Abbott’s FreeStyle Libre system is designed to change how people with diabetes measure their glucose levels and ultimately help them achieve better health outcomes. The system reads glucose levels through a sensor worn on the back of the upper arm, eliminating the need for routine finger pricks.

The device allows people with diabetes to monitor glucose levels conveniently and painlessly without routine finger-prick tests and to have information about glucose levels throughout the day, enabling them to adjust food intake, exercise and insulin doses more effectively to avoid either high glucose levels or dangerously low blood glucose levels.

About ABCD

ABCD is the association of diabetes specialist consultants in the UK and has previously conducted national audits of medications as they are introduced into real world usage in the NHS (

The ABCD audit, an independent national audit supported by an unrestricted educational grant from Abbott, looks at the real-world experience of patients using the FreeStyle Libre system and how it impacts their glycaemic control. Clinicians are invited to submit the data they collect to a secure web-based tool held within the NHS network.

About Haemoglobin A1c

Haemoglobin A1c is a blood test which reflects the level of blood glucose control in a person over the previous 2-3 months.

For more information, please contact

Dr Harshal Deshmukh, Clinical Lecturer in Endocrinology and Diabetes, University of Hull

Dr Emma Wilmot, Consultant in Diabetes, University Hospitals of Derby and Burton NHS Trust

Dr Chris Walton, Consultant in Diabetes, Hull University Teaching Hospitals NHS Trust

Dr Bob Ryder, Consultant in Diabetes, Sandwell and West Birmingham Hospitals, NHS Trust

Prof Thozhukat Sathyapalan, Professor of Diabetes and Endocrinology, Hull York Medical School, University of Hull