Background and Aims

Diabetes technology use in type 1 diabetes (T1D) management is an increasingly widespread practice. Patient-related outcomes are crucial in the management of diabetes technology. The aim of the study was to analyse the relationship between diabetes technology use and the psychosocial repercussions associated with T1D.

Methods

Patients with T1D who participated in a training program to start CSII, CGM, or SAP were asked to complete some questionnaires: Gold score (GS), Clarke score (CS), Hypoglycaemia Fear Survey (HFS), Diabetes Quality of Life (DQoL), Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Pittsburgh Sleep Quality Index (PSQI).

Results

176 T1D patients were included: age 38±12, 52% men, diabetes duration 18±11 years, HbA1c: 7.4±1.0%. 20% severe hypoglycaemia (last year). Previous treatment: CSII: 18% (n=31), CGM: 10% (n=18), SAP: 13% (n=23).

HFS was higher in patients on MDI compared to patients on CSII (51±25 vs 42±23, p=0.043) DTSQ score was higher in CSII user (30±6 vs 25±6, p<0.0005), CGM (29±7 vs 26±6, p=0.007) or SAP (30±7 vs 26±6, p=0.002) compared to non-users. PSQI was not different in device users vs non-users, being HFS the main predictor of PSQI (p=0.006) in the multivariate analysis. Predictors of DQoL were PSQI (p=0.004), HFS-worry subscale (p=0.012) and DTSQ (p=0.005). HbA1c was not an independent predictor of psychological outcomes.

Conclusions

Patient-related outcomes need to be considered when managing diabetes technology. Diabetes devices help to reduce fear of hypoglycaemia and improve diabetes satisfaction. The relationship between sleep quality and diabetes technology use could be related to improvement of fear of hypoglycaemia and quality of life.