OBJECTIVES: The FreeStyle Libre system (FSL) was reimbursed in Portugal for people with type 1 and 2 diabetes (T1DM, T2DM) beginning 2018. Since then, a yearly nationwide survey in community pharmacies was set up to measure the impact of FSL on patients’ behavior, including blood glucose strip consumption.

METHODS: In 2022, a random sample from 1,500 pharmacies affiliated with the Portuguese National Association of Pharmacies was invited to participate. The study captured self-reported data from privately- or publicly-insured patients at the time of FSL sensor purchase. Study was powered to estimate national proportions with maximum absolute error 3.0% and 95% confidence level.

RESULTS: 194 pharmacies participated, providing a total of 1,073 completed surveys. All regions of Portugal were represented; average regional coverage rate was 6.6%. Percentage of users aged 18-to-64, 65+, and ≤17 was 61.2%, 29.9%, and 8.9%, respectively. Over half (54.9%) of FSL users were T1DM, one-third (33.2%) were T2DM treated with multiple daily injections of insulin (MDI), and a fraction (9.2%) were T2DM non-MDI. The majority (71.3%) indicated using the FSL sensor for more than 1 year. Overall, FSL users indicated utilizing a mean of 5.3 strips/day prior to adoption of FSL, decreasing to 1.1 strips/day (p<0.001) post-adoption (a 79% reduction). Strip use pre-FSL was greater for younger users (7.9 and 6.1 strips/day for users ≤12 and 13-to-17 years of age, respectively), while more moderate among older users (5.5 and 4.4 strips/day for users 18-to-64 and adults 65+, respectively). T1DM users reported the greatest reduction in strip use (a 78% reduction) from 6.0 to 1.3 strips/day. T2DM MDI and non-MDI users had a similar strip reduction (84% and 82%) from 4.5 strips/day to 0.7 and 0.8 strips/day, respectively.

CONCLUSIONS: FSL users in Portugal reported a reduction in strip use, irrespective of age, diabetes type, or duration of sensor use.