Background and Aims

Flash Glucose Monitoring (FGM) is associated with significant improvements in HbA1c but the impact on quality of life (QoL) stays unknown. This study aimed to examine the effect of FGM on glycemic control and QoL in a cohort of adults with Type 1 Diabetes.

Methods

We undertook a prospective, real-world, case-control study with a six-month follow up involving patients treated with multiple insulin injections. Individuals who started with a FGM system for the first time (cases) were compared with those who were using it previously (controls). The end points were metabolic outcomes and the scores of QoL questionnaires (EsDQUOL and Hypoglycemia Fear Survey-HFS-).

Results

41 patients were included in the case group ( 61% women, mean age: 42,8 ±12,1 years, diagnosed for 1-53 years, mean HbA1c: 7,6% ± 1,2) and 23 patients in the control group (52% women, mean age: 42,8 ± 16,1 years, diagnosed for 1-40 years, mean HbA1c: 7,1% ± 0,7). EsDQUOL score improved in the case group (96,53 vs 83,58 after 6 months; p=0,005) but not in the control group. There were no significant differences in HbA1c or in the rest of the analyzed outcomes (Body Mass Index, dose of insulin/kg, rapid insulin percentage, severe hypoglycemias and HFS score).

Conclusions

FGM could improve QoL of patients with Type 1 Diabetes. Additional studies with a larger number of patients and a longer follow up are probably needed to observe changes in metabolic outcomes.

Background and Aims

There are different therapeutic approaches for type 1 diabetes mellitus (T1DM) based on new technologies such as continuous subcutaneous insulin infusion (CSII) or flash glucose monitoring system (FGMS). Our objective is to assess clinical and QoL impact of three different therapeutic strategies: multiple daily insulin injections (MDI), CSII and MDI+FGMS.

Methods

cross sectional study assessing glucose control and diabetes and hypoglycaemia fear quality of life questionnaires (DQoL and HFS respectively) in 41 T1DM patients on MDI treatment, 42 on CSII and 23 on MDI+FGMS from a university hospital in the North of Spain

Results

mean age was similar in the three groups (42.8-43.8 years, ns). Women were 52-70% in the three groups (ns). Educational status was different amongst groups: 37% university degree in MDI, 64% in CSII and 65% in MDI+FGMS (p<0.05). Patients from CSII group had longer duration of the disease: 24.5 years (7-59) vs MDI 15 (2-36) and MDI+FGMS 18 (1-40) groups (p<0.001). Mean HbA1c showed a non-significant trend towards lower values in MDI+FGMS (7.1±0.7%) vs CSII (7.4±0.8) and MDI (7.6±1.1) groups. MDI+FGMS users had a near to significance trend to better score in DQoL test vs patients from the other two groups (80.5 vs 90 (MDI) and 92.5 (CSII) p=0,09) and showed a non-significant trend in the HFS test towards less hypoglycaemia fear scores.

Conclusions

There is a trend to better glycaemic control, better diabetes related QoL and less hypoglycaemia fear in T1DM patients on MDI+FGMS vs CSII and MDI

Background and Aims

Whether metabolic outcomes improve with continuous subcutaneous insulin infusion (CSII) more than with glucose monitoring systems in patients with type 1 diabetes mellitus (T1DM) remains controversial.

Objective: to assess metabolic changes after CSII or flash glucose monitoring system (FGMS) implementation in T1DM patients from a university hospital in the North of Spain

Methods

prospective and real-life study assessing metabolic outcomes in 110 T1DM patients on multiple daily insulin injections (MDI) before and 1 year after FGMS (41 patients) and CSII (69 patients) implementation.

Results

mean age and gender were similar between groups (42,8 and 44,4 years and 61-63% women). Patients on CSII had longer duration of diabetes: 25 vs 17 years (p<0,005) and more non-proliferative retinopathy (61 vs 12%) rates than patients on MDI+FGMS but there were no differences on proliferative retinopathy and nephropathy. Mean HbA1c was higher at baseline in CSII patients than in MDI+FGMS (7,9±0,9 vs 7,6±1,1%, p<0,05). There were no differences in mild and severe hypoglycaemia episodes, hypoglycaemia unawareness or ketoacidosis between the two groups at baseline. Patients on CSII showed a change in HbA1c (-0,36%, p<0,001) 1 year after but patients on MDI+FGMS did not (-0,16%, ns). There were no differences in mild hypoglycaemia or ketoacidosis in both groups 1 year after. Both groups experienced less severe hypoglycaemia episodes and hypoglycaemia unawareness 1 year after than in baseline (p<0,05).

Conclusions

T1DM patients starting CSII underwent a greater improvement than MDI+FGMS 1 year after. Both groups showed improvement in severe hypoglycaemia and hypoglycaemia awareness.