RT-CGM in adults with type 1 diabetes improves both glycaemic and patient-reported outcomes, but independent of each other

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.