To examine in adults with type 1 diabetes (a) the effect of initiation of real-time continuous glucose monitoring (RT-CGM) on glycaemic and patient-reported outcomes (PROs), and (b) factors related to clinically relevant improvements and sustained device use.
60 persons initiating RT-CGM completed questionnaires at device start and six months later. Demographics and clinical characteristics including (dis)continuation up until July 31st 2018 were obtained from medical records.
After six months, 54 adults were still using RT-CGM. Short-term discontinuation (10%) was mainly related to end of pregnancy (wish). Longer-term discontinuation in those with an initial non-pregnancy indication was related to changes in the medical condition and behavioural/psychological reasons. After six months, HbA(1c), diabetes-specific worries and self-efficacy improved (range d = vertical bar 0.4 vertical bar-vertical bar 0.8 vertical bar), while hypoglycaemia rate or awareness and more general distress did not change. More suboptimal scores at baseline were related to meaningful improvements in HbA(1c) (>= 10 mmol/mol; 0.9%) and PROs (>= 0.5 SD). Changes in glycaemic variables and PROs were not related.
People with more suboptimal HbA(1c) and PRO values appear to benefit most from RT-CGM. Given the lack of association between improvements in medical outcomes and PROs, both should be included in evaluations of RT-CGM therapy on an individual level. (C) 2019 Elsevier B.V. All rights reserved.
- Continuous glucose monitoring
- Regular care
- Glycaemic outcomes
- Patient-reported outcomes
- IMPAIRED AWARENESS