Abstract
Aims:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Original language | English |
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Article number | 107910 |
Number of pages | 9 |
Journal | Diabetes Research and Clinical Practice |
Volume | 158 |
DOIs | |
Publication status | Published - 2019 |
Keywords
- Continuous glucose monitoring
- Regular care
- Glycaemic outcomes
- Patient-reported outcomes
- Distress
- Coping
- IMPAIRED AWARENESS
- HYPOGLYCEMIA
- QUALITY
- MODEL
- LIFE