Abstract Body

Continuous glucose monitoring (CGM) is increasingly used amongst people with type 1 diabetes, type 2 diabetes and pre-diabetes as a tool to visualise glycemic patterns and excursions. The are widely reported clinical benefits across different systems and study designs. There are also a number of downsides that contribute to discontinuation of CGM use including increased visibility of disease state, alarm fatigue and interference in daily living. Effective onboarding of such systems, including exploration of personalised expectations and goals can mitigate these downsides. This presentation will explore benefits and burdens of CGM systems, as well as provide practical tips and advice on how to get the best out of them for improved physical and mental wellbeing.

Abstract Body

Automated insulin delivery (AID) systems are increasingly being used by children of all ages with type 1 diabetes. Glycemic benefits have been widely reported, with a 70% time in target range reported to be clinically beneficial. The impact of such systems on the quality of life and psychosocial functioning of children and their parents, however, is less well understood. This presentation will explore some of the benefits and burdens of AID technology use amongst young children with type 1 diabetes. These will include competing priorities between children and their parents; relationships with other caregivers and balancing diabetes management with simply growing up. Finally, appropriate ways to assess patient reported outcomes will be explored.

Background and Aims

Background: Existing therapeutic interventions to treat diabetes are well known, yet the majority of people with diabetes do not consistently achieve blood glucose targets (even individual therapy targets) for optimal health, despite the large range of treatment options available. Such outcomes have remained stubbornly poor for decades with <25% adults with diabetes achieving glycaemic targets. The medical healthcare model is not ideally suited to supporting effective diabetes management. In routine clinical care, patient-identified priority concerns may be missed by the care team.

Aim: To determine clinical and cost effectiveness of the Spotlight-AQ Pre-clinic assessment and mapped care planning intervention in a multi-centre RCT

Methods

Participants: Adults with type 1, type 2 or pre-diabetes attending routine care outpatient appointments.

Design: Multi-centre, parallel group, individually randomised trial comparing consultation duration in adults with type 1, type 2 or pre-diabetes using the Spotlight Consultations pre-clinic assessment compared to usual care in the Spotlight-AQ study.

Intervention: An outpatient pre-clinic intervention delivered within one week prior to scheduled routine outpatient appointment.

Sample size: 200 recruited

Results

Primary outcome measure: Duration of routine outpatient consultation.

Secondary outcome measures:

Functional health status

Diabetes distress

Depression

Treatment satisfaction

Impact on self-care behaviours

HCP burnout

HCP treatment satisfaction and burden

Hypoglycaemia (time less than 70mg/dL)

Hyperglycaemia (time above 180 mg/dL)

Change in weight

Change in HbA_1c

Cost effectiveness of intervention

Trial Registration: ISRCTN15511689

Conclusions

Preliminary results will be presented with implications for routine care delivery in terms of reducing healthcare professional burnout whilst improving physical and mental health outcomes for people with diabetes