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Jiménez-Sahagún R, Gómez Hoyos E, Díaz Soto G, Nieto de la Marca MDLO, Sánchez Ibáñez M, Del Amo Simón S, Torres Torres B, López Gómez JJ, Delgado García E, Ortolá Buigues A, de Luis Román D. Impact of flash glucose monitoring on quality of life and glycaemic control parameters in adults with type 1 diabetes mellitus⋆. ENDOCRINOL DIAB NUTR 2022; 69:345-353. [PMID: 35570137 DOI: 10.1016/j.endien.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Flash glucose monitoring (FGM) improves some glycaemic control variables and quality of life parameters. OBJECTIVE Our aim was to evaluate the quality of life and glycaemic control parameters after initiating FGM in patients with type 1 diabetes (DM1) in clinical practice. MATERIAL AND METHODS A prospective observational study in DM1 patients that started using FGM between June 2019 and April 2020. We analysed their scores on the Diabetes Quality of Life (DQOL) questionnaire, Diabetes Distress Scale (DDS), Diabetes Treatment Satisfaction Questionnaire (DTSQ) and glycaemic control parameters at baseline and 3 months after the FGM onset. RESULTS We recruited 114 patients, 56% male, mean age 37.2 (standard deviation, SD 12.4), with 18.7 (SD 11.5) years of DM1, 24.6% of which used continuous subcutaneous insulin infusion. Differences were observed (baseline vs. 3 months) in the DTSQ score (22 [15.5-27] vs. 25 [22-28], P < 0.001) and in the DQOL score (88 [74-104] vs. 84 [70-101], P = 0.017) but not in the DDS score. HbA1c was 7.8% (SD 1.3) vs. 7.4% (SD 1.1) (P < 0.001), without improvement in other glycaemic control variables, except for the mean number of hypoglycaemic events/14 days: 14 (SD 9) at baseline vs. 11.5 (SD 7) at 3 months (P < 0.001). CONCLUSIONS The initiation of FGM, combined with a structured educational programme, was associated with improvement in quality of life and patient satisfaction in DM1 patients. An improvement in HbA1c and a reduction in the number of hypoglycaemia events was observed, but not in the rest of glycaemic control parameters.
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Affiliation(s)
- Rebeca Jiménez-Sahagún
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain.
| | - Emilia Gómez Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | - Gonzalo Díaz Soto
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | | | - Marta Sánchez Ibáñez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Sofía Del Amo Simón
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Beatriz Torres Torres
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | - Juan José López Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | - Esther Delgado García
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | - Ana Ortolá Buigues
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
| | - Daniel de Luis Román
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición (IENVA), Facultad de Medicina, Valladolid, Spain
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Moreno-Fernandez J, López LM, Gomez FJ, Pinés P, Blanco B, González J, López J, Herranz S, Roa C, Gómez-Romero FJ. Long-term effects of continuous subcutaneous insulin infusion in adults with type 1 diabetes mellitus patients: Results of a public healthcare system. ACTA ACUST UNITED AC 2020; 68:116-122. [PMID: 32007441 DOI: 10.1016/j.endinu.2019.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/11/2019] [Accepted: 10/30/2019] [Indexed: 12/27/2022]
Abstract
AIM To evaluate the long-term clinical effect of continuous subcutaneous insulin infusion (CSII) in adult type 1 diabetes mellitus (T1DM) patients in a regional public healthcare system real-world scenario. METHODS All adult T1DM patients on CSII for ≥10 years subjected to follow-up in the regional Castilla-La Mancha Public Health Service were included. The primary efficacy outcome was the variation in HbA1c during follow-up. Direct patient data were compiled through the web-based Spanish national registry on CSII therapy. RESULTS A total of 69 T1DM adult patients were treated with insulin pumps for ≥10 years in our region. The mean age was 45.0±10.5 years, with a T1DM duration of 13.9±8.5 years. The mean duration of CSII therapy was 11.4±2.1 years. The main indications for treatment were high glucose variability (39%), problematic hypoglycemia (26%), and HbA1c >53mmol/mol (7%) on multiple daily injections (20%). Sensor-augmented pump therapy was used by 31% of the patients. Glycosylated hemoglobin did not change during follow-up (58±11mmol/mol vs. 58±11mmol/mol; 7.5±1.0 vs. 7.5±1.0; p=0.66). However, the percentage of patients with at least one episode of severe hypoglycemia during the last year and unnoticed hypoglycemia decreased from 36% to 7% (p=0.006) and from 38% to 32% (p<0.001), respectively. The proportion of subjects with ≥1 episode of diabetic ketoacidosis in the last year decreased from 30% to 6% (p=0.045). CONCLUSIONS The reduction of severe hypoglycemia without deterioration of glycemic control can be sustained over long-term CSII therapy.
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Affiliation(s)
- Jesus Moreno-Fernandez
- Service of Endocrinology and Nutrition, Ciudad Real University Hospital, Ciudad Real, Spain.
| | - Luz María López
- Service of Endocrinology and Nutrition, Albacete University Hospital, Albacete, Spain
| | - Francisco Javier Gomez
- Service of Endocrinology and Nutrition, La Mancha-Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain
| | - Pedro Pinés
- Service of Endocrinology and Nutrition, Albacete University Hospital, Albacete, Spain
| | - Benito Blanco
- Service of Endocrinology and Nutrition, Nuestra Señora del Prado Hospital, Talavera de la Reina, Toledo, Spain
| | - Javier González
- Service of Endocrinology and Nutrition, Virgen de la Luz Hospital, Cuenca, Spain
| | - José López
- Service of Endocrinology and Nutrition, Virgen de la Salud Hospital, Toledo, Spain
| | - Sandra Herranz
- Service of Endocrinology and Nutrition, Guadalajara University Hospital, Guadalajara, Spain
| | - Carlos Roa
- Service of Endocrinology and Nutrition, Santa Barbara Hospital, Puertollano, Ciudad Real, Spain
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