Oral Abstract Presentation

DCO1 - Clinical Care and Education Oral Abstract Presentations: The Libre Enabled Reduction of A1c Through Effective Eating and Exercise Study (LIBERATE): A real-world cohort study compared to usual specialist diabetes care

Friday, November 28, 2025

14:30 - 15:45 Toronto

Location: Room 206

Presenting Author(s)

Sonja M. Reichert, MD, MSc, FCFP, ABOM Diplomat, Co-Chair: Clinical Care and Education Stream (she/her/hers)

Associate Professor, MD
Western University
Western University
London, Ontario, Canada

Disclosure(s): Abbott: Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support) (Ongoing), Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing), Speaker/Honoraria (Ongoing); American Diabetes Association: Independent Contractor (Terminated, September 1, 2025); Bausch: Advisory Board (Terminated, November 1, 2024); Bayer: Advisory Board (Terminated, June 9, 2025); Center for Effective Practise: Employment (Terminated, January 1, 2025); CPD Network Association: Speaker/Honoraria (Terminated, September 23, 2025); Diabetes Canada: Committee/Planning Member (Ongoing); Eisai: Advisory Board (Terminated, November 20, 2024); Eli Lilly: Advisory Board (Ongoing), Grant/Research Support (Ongoing); Embecta: Advisory Board (Terminated, November 21, 2024); Novartis: Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing); Novo Nordisk: Advisory Board (Terminated, March 1, 2025), Committee/Planning Member (Terminated, March 1, 2025), Grant/Research Support (Terminated, March 1, 2025), Speaker/Honoraria (Terminated, March 1, 2025); Sanofi: Speaker/Honoraria (Terminated, June 4, 2025); Western University: Employment (Ongoing), Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing)

Disclosure(s):

Sonja M. Reichert, MD, MSc, FCFP, ABOM Diplomat, Co-Chair: Clinical Care and Education Stream: Abbott: Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support) (Ongoing), Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing), Speaker/Honoraria (Ongoing); American Diabetes Association: Independent Contractor (Terminated, September 1, 2025); Bausch: Advisory Board (Terminated, November 1, 2024); Bayer: Advisory Board (Terminated, June 9, 2025); Center for Effective Practise: Employment (Terminated, January 1, 2025); CPD Network Association: Speaker/Honoraria (Terminated, September 23, 2025); Diabetes Canada: Committee/Planning Member (Ongoing); Eisai: Advisory Board (Terminated, November 20, 2024); Eli Lilly: Advisory Board (Ongoing), Grant/Research Support (Ongoing); Embecta: Advisory Board (Terminated, November 21, 2024); Novartis: Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing); Novo Nordisk: Advisory Board (Terminated, March 1, 2025), Committee/Planning Member (Terminated, March 1, 2025), Grant/Research Support (Terminated, March 1, 2025), Speaker/Honoraria (Terminated, March 1, 2025); Sanofi: Speaker/Honoraria (Terminated, June 4, 2025); Western University: Employment (Ongoing), Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing)

Blinded Abstract: Introduction and

Objective:
The LIBERATE study aimed to evaluate the efficacy of a real world, standardized, six-month, virtual group diabetes self-management education (DSME) program, which incorporated isCGM to support behaviour change.

Methods
Participants with T2D and HbA1c  8% were recruited for this prospective study. LIBERATE included virtual DSME every two weeks for the first 12 weeks and monthly for the last 12 weeks. Participants used the FreeStyle® Libre 2 for glucose monitoring continuously during the first three months and had the option to use three sensors thereafter. Group sessions were facilitated by a CDE with content based on current DSME principles emphasizing isCGM data. Primary outcome was percent mean change in HbA1c. To compare the effects of LIBERATE to usual specialist care, a group of participants eligible for LIBERATE were identified using a retrospective chart review (T2D and HbA1c  8%, 6-months+ of specialist T2D care). The groups were compared on A1c and DM medication use using T-tests.

Results
In 92 participants LIBERATE significantly improved HbA1c from 9.8% ( 1.5%) to 7.6% ( 1.2%), p< 0.01 at endpoint. Overall glycemic agents were significantly reduced from 2.3 medications to 1.7 medications at endpoint (p < 0.001). In 308 specialist care participants, HbA1c significantly improved from 9.2% ( 1.2%) to 8.4% (1.3%), p< 0.01. However, glycemic agents significantly increased from 2.8 medications to 3.1 medications at endpoint (p < 0.001).

Conclusion
Combining six months of virtual DSME with isCGM technology improved HbA1c beyond traditional specialist diabetes care, including for those not yet on insulin therapy.