Impact of intermittently scanned continuous glucose monitoring on quality of life and glycaemic control in persons with type 1 diabetes: A 12-month follow-up study in real life. Issue 6 (June 2022)

• Record Type: Journal Article
• Authors: Duarte, Diana Borges; Fonseca, Liliana; Santos, Tiago; Silva, Vânia Benido; Puga, Francisca Marques; Saraiva, Miguel; Silva, Isabel L.; Teixeira, Sofia; Vilaverde, Joana; Cardoso, Maria Helena
• Is Part Of: Diabetes & metabolic syndrome. Volume 16:Issue 6(2022)
• Publication Date: 2022-06
• Subjects: Flash glucose monitoring -- Type 1 diabetes mellitus -- Quality of life -- Glycaemic variability -- Hypoglycaemia; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2022.102509
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Background and aim: We sought to prospectively assess the impact of intermittently scanned continuous glucose monitoring (isCGM) initiation in the glycaemic control and quality of life (QoL) in type 1 diabetes mellitus (T1DM) patients followed in real-live conditions. Methods: Prospective, observational, cohort, single-centre and single-arm study conducted between September 2018 and March 2020, enrolling adults with T1DM with at least one year of diagnosis, interested in using isCGM. After training at isCGM initiation, CGM metrics and QoL were assessed at baseline and 12 months. Results: Thirty-six individuals (55.6% male) were included; median age at inclusion was 49.0 (43.5–62.5)years and the mean(±SD) duration of T1DM was 25.5 ± 12.0 years. Median (interquartile range) HbA1c decreased from 7.6(7.0–8.7)% to 7.4(6.8–7.7)% at 12 months (p = 0.02), driven by the subgroup of individuals with baseline HbA1c ≥ 7.5%. The number of scans per day increased from 7.0(5.5–10.0) to 10.0(7.0–14.0) but no correlation was found between the number of daily scans and CGM metrics. Total daily insulin dose remained unchanged, however the proportion of basal insulin decreased, and the proportion of bolus insulin increased over time. Multiple QoL subscales scores improved significantly, including disease-burden subscale for which TIR proved to be a significant predictive factor. Conclusion: isCGM improved both glycaemic control, namely time in range, time below range and glycaemic variability, as well as QoL scores in the long term. The increase of the bolus insulin proportion suggests a behavioural change. However, the appraisal of our results must consider our substantial rate of drop-out limiting the external validity of our findings. Highlights: Intermittently scanned continuous glucose monitoring improves glycaemic control and glycaemic variability in the long term. Time in range proved to be a significant predictor of quality of life in persons with type 1 diabetes. Intermittently scanned continuous glucose monitoring seems to drive a behavioural change.