The FreeStyle Libre Flash Technology System

Association of British Clinical Diabetologists

FreeStyle Libre Nationwide Audit

Home Live ABCD audits of new therapies and devices All ABCD nationwide audits Future audits of new therapies ABCD worldwide audits
The FreeStyle Libre Flash Technology System

Above - Flash glucose monitoring (Flash GM) is a new technology that has recently been made available on the NHS Drugs Tariff. Click here to see the consensus guidelines

FSL leads to less hypos 

Above: The REPLACE and IMPACT RCTs demonstrated that the FreeStyle Libre system achieved significant reductions in hypoglycaemia compared to Self Monitoring of Blood Glucose (SMBG) - click to enlarge

FSL leads to less nocturnal hypos

Above: The REPLACE and IMPACT RCTs showed that the time spent in nocturnal hypoglycaemia compared to SMBG - click to enlarge

FSL less hypos but not at expense of HbA1c 

Above: The REPLACE and IMPACT RCTs showed that the reductions in hypoglycaemia were not at the expense of HbA1c - click to enlarge

FSL led to more checking of the glucose level

Above: In the REPLACE and IMPACT RCTs The FreeStyle Libre system lead to a rapid and sustained increase in testing frequency and a reduction in the use of SMBG - click to enlarge

ABCD nationwide FreeStyle Libre (FSL) audit

ABCD nationwide FSL audit our first device audit
This nationwide audit, our first of a device, launched in November 2017. An online tool was launched in August 2018. Following deadlines for data analysis in December 2018 and May 2019, presentations from the audit were made at Diabetes UK APC in Liverpool in March 2019 and ADA 79th scientific sessions in San Francisco in June. These early findings were very positive and were summarised by Dr Chris Walton in an ABCD press release on 11 June, 2019. In June 2020 the first full paper from the audit was published in Diabetes Care and it is free to download. Further analysis of this data is ongoing. It is important to stress that the audit continues and it is particularly important that follow up data is submitted as your patients return to see you in the months ahead.

About the ABCD nationwide FSL audit
With the launch of the FSL audit, ABCD is now auditing the use of FSL in adults and paediatric patients with both type 1 and type 2 diabetes. On the left you will find examples of findings from randomised controlled trials (RCTs) undertaken with FSL. As with the other ABCD audits ( for example exenatide, liraglutide, dapagliflozin), it may be that outcomes for patients using FSL in real clinical practice will be different from those in the clinical trials. It is the aim of this audit to find this out. As with other audits, this audit will again be hosted on HSCN with the latest version of NHSnet. Access the on-line tool for the audit does require the user to be on HSCN – ie in an NHS hospital, GP surgery etc. The on-line tool became available for general use on August 28, 2018. Paper forms are also available from the links below to assist with data collection prior to entry into the on-line tool. The audit has a number of objectives.  During 2019 the online audit tool has been edited and improved in the light of experience and data collection forms have been modified to the ones downloadable from this page.

Web-based audit tool on HSCN
The audit tool for the FSL audit is similar to that being used for the other ABCD audits. The tool is easy to use. Being on HSCN it has optimum security for patient identifiable data with regard to your own patients, but anonymises the data when it is utilised in the national audit. There are some special features with regard to the data export both for your own local analysis and for the nationwide analysis. The export now allows you to choose which data to download for analysis as well as providing all data. It also allows you to choose to download the data aggregated to different time points.  The tool has the facility to detect data from the same patient entered in two sites (eg hospital and primary care) and to merge the data when exported - see centres and sites below.  

Structure of the audit – centres and sites
For this audit the concept of centres and sites is utilised in the same way as in the other ABCD audits. Typically, a centre might be an NHS Trust. Sites might be hospitals associated with that Trust, and/or health centres or GP surgeries in the local vicinity. If set up in this structure, designated leaders of the local audit would be given access to download the anonymised data of all the patients associated with the centre for more powerful local analysis of data involving higher numbers. Findings so made through such local analysis could be put forward for further testing on the full national dataset.

Collect data on-line or via paper forms
The on-line audit tool will be so easy to use that live data entry in clinic is a real option to be considered. Otherwise to facilitate data collection during clinics there are two paper forms which exactly match the data that can be entered into the audit tool. You can download and print these forms locally or order pre-printed data entry forms.

To download the forms to printout for use, use the following links:
Download first visit data entry form
Download follow up visit data entry form

Non ABCD members
Non ABCD members are welcome to take part in the audit and will be given access to the on-line audit tool when they
register for the audit.

Data from children
This may also be added thanks to a collaboration between ABCD, the Association of Children's Diabetes Clinicians (ACDC) and the Children and Young People’s Diabetes Network.

Register to take part in the audit and access to the on-line tool
To register for the audit and be given access to the on-line tool on the ABCD website on N3 click here.

Northern Ireland and Worldwide
As Northern Ireland is not on
HSCN, a non HSCN version of the tool has been developed which can allow any country in the world to enrol at no cost and utilise the facilities. Any country, and centres in the country, may collect and analyse their own data which will then automatically become part of worldwide audit. For more information click here. To register for the audit if you from Northern Ireland or outside the UK click here

How to do it videos
Videos showing how to analyse your data in the ABCD FreeStyle Libre audit have now been created and are available to watch on the ABCD YouTube channel.

Caldicott Guardian approval
The ABCD nationwide audit programme has Caldicott Guardian approval. The programme is audit not research. The NHS encourages audit of clinical practice and there are strict guidelines which we follow, in particular that we only to collect data from routine clinical practice, and analysis is of data which is anonymised.

Further information
Further enquiries may be made to the ABCD nationwide audits database administrator of the project, Melissa Cull.


   Register for the FreeStyle Libre audit: UK

Register for the FreeStyle Libre audit: Northern Ireland, Isle of Man and non-UK

Access the on-line tool
(UK: you need to be on N3)

Access the worldwide on-line tool
(Northern Ireland and non-UK)

FreeStyle Libre audit objectives

Order preprinted data entry forms

Download first visit data entry form

Download follow up visit data entry form

Download first visit data entry form (editable)

Download follow up visit data entry form (editable)

How to analyse your data - video

Papers, abstracts, presentations, posters from the audit

Further information- contact us

ABCD on N3 homepage

Main ABCD homepage


The ABCD nationwide FreeStyle Libre audit is an independent audit supported by an unrestricted grant from Abbott

Working to support high quality diabetes care in the UK