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Diabetes Res Clin Pract. 2019 Oct 31:107910. doi: 10.1016/j.diabres.2019.107910. [Epub ahead of print]

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

Author information

1
Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, The Netherlands; Tilburg University, Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg, The Netherlands; Diabeter, National treatment and research center for children, adolescents and young adults with type 1 diabetes, Rotterdam, The Netherlands. Electronic address: Giesje.Nefs@radboudumc.nl.
2
Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, The Netherlands.
3
Radboud university medical center, Department of Internal Medicine, 463, Nijmegen, The Netherlands.

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, HbA1c, diabetes-specific worries and self-efficacy improved (range d=|0.4|-|0.8|), while hypoglycaemia rate or awareness and more general distress did not change. More suboptimal scores at baseline were related to meaningful improvements in HbA1c (≥10 mmol/mol; 0.9%) and PROs (≥0.5 SD). Changes in glycaemic variables and PROs were not related.

CONCLUSIONS:

People with more suboptimal HbA1c 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.

KEYWORDS:

continuous glucose monitoring; coping; distress; glycaemic outcomes; patient-reported outcomes; regular care

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