Can we prevent recurrent severe low blood glucose reactions using a new glucose sensing device?

Patients with a documented episode of severe hypoglycaemia will be randomised to the Flash Libre subcutaneous glucose sensing system or usual care over a 6-month follow-up period. The Flash Libre device is an adhesive sensor disc with a thin needle that is placed on the upper arm and which can be read as required. Each sensor lasts 2 weeks before it has to be replaced (patients allocated to this arm will be using the device continuously for 6 months) and is precalibrated so that the patient does not need to do any finger prick blood glucose readings. The readings can be downloaded to a PC which will also be access by the Study Nurse to assess compliance. Training on use of the Flash Libre system will be implemented by the Study Nurse but the patients themselves will insert each sensor, and perform data collection at least 4 times per day and when a hypoglycaemic episode is suspected. The Research Nurse will also co-ordinate usual care for those randomised to this arm. Both intervention (Flash Libre) and usual care patients will have a 30-minute face-to-face session with the Research Nurse as soon as possible after the index severe hypoglycaemic episode. The Nurse will perform a review of medication and self blood glucose monitoring, re-educate patients as to avoidance measures and ensure that the patient's usual health care professionals are aware of the hypoglycaemic episode so that they can take over care in the community.