Skip to main content

Flash glucose monitoring use associated with a reduction in diabetes distress

Users of the FreeStyle Libre system in the UK show improvements in glycaemic control and awareness of hypoglycaemia which are associated with improvement in diabetes-related distress, according to a new study1 by Dr Harshal Deshmukh, from Hull University Teaching Hospitals NHS Trust, and colleagues.

Diabetes-related distress - the result of dealing with the unrelenting demands and limitations inflicted on the person living with diabetes - is an important determinant of suboptimal glycaemic control and complications in people living with Type 1 diabetes. Understanding the cause of diabetes-related distress in this group is important so healthcare professionals can suggest strategies to alleviate it to improve the quality of life of people living with diabetes.

This real-world study used data from the nationwide audit of FreeStyle Libre conducted by the Association of British Clinical Diabetologists (ABCD). Data were collected at baseline for 9,159 patients (96.6% living with Type 1) before FreeStyle Libre initiation and at seven months’ follow-up for 3,312 of these patients. The results are published in the latest issue of Diabetes, Obesity and Metabolism1

At baseline, researchers collected data on HbA1c values (level of glucose control in a person over the previous 2-3 months), Gold score (a measure of hypoglycaemia awareness) and diabetes-related distress scores. The researchers used the two-item diabetes distress instrument which assesses feelings of being overwhelmed by the demands of living with diabetes and the feeling of often failing with the diabetes regimen.

At follow-up, they collected data on diabetes distress score, HbA1c, Gold score and number of scans per day with the FreeStyle Libre system, as well as time in range.

The researchers found that in this large cohort of people living with Type 1 diabetes, moderate to severe diabetes-related distress was prevalent (53%) and associated with higher HbA1c, impaired awareness of hypoglycaemia and women were more affected than men.

Their analysis at follow-up showed that, with the use of the FreeStyle Libre system, moderate to severe distress prevalence reduced from 50% to 26%. These improvements in diabetes distress were associated with lower follow-up HbA1c and lower Gold score.

This is the largest UK study looking at factors associated with diabetes distress scores in people with Type 1, before and after the use of FreeStyle Libre. The use of flash glucose monitoring was associated with an improvement in diabetes-related distress. Engagement with technology is an empowering way for people living with diabetes to self-manage their condition effectively – with both physical and psychological benefits.” said Dr Harshal Deshmukh.


  1. Deshmukh et al (2021) Predictors of Diabetes-related Distress (DRD) before and after FreeStyle Libre-1 use: Lessons from Association of British Clinical Diabetologists (ABCD) nationwide study. Diabetes, Obesity and Metabolism doi: 10.1111/dom.14467

Note 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 dose more effectively to avoid either high glucose levels or dangerously low 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.

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