medwireNews: Continuous glucose monitoring (CGM) is associated with improvements in diabetes-specific quality of life (QoL) compared with self-monitoring among patients with type 1 diabetes who use multiple daily insulin injections (MDI), study results suggest.
In an analysis of data from the DIAMOND trial, the researchers found that mean Hypoglycemic Confidence Scale (HCS) scores increased from 3.27 at baseline to 3.47 at week 24 among 102 patients receiving CGM, compared with an increase from 3.15 to 3.18 in 53 patients who self-monitored their blood glucose levels.
These findings translate into a significant mean difference of 0.23 between the two groups, report William Polonsky (University of California, San Diego, USA) and colleagues in Diabetes Care.
When assessing individual items of the HCS, the team found “the most striking” between-group differences in participants’ reports of feeling safe from serious hypoglycemic problems during sleep and when driving, in addition to their partners’ overall hypoglycemic confidence.
Furthermore, Diabetes Distress Scale (DDS) scores decreased from a mean of 1.78 at baseline to 1.61 at week 24 among participants using CGM, but increased from 1.69 to 1.78 in the self-monitoring group (mean between-group difference=0.22).
The differences in diabetes-specific QoL persisted after adjustment for demographic factors.
These results support the hypothesis that “CGM can help adults with [type 1 diabetes] to regain or enhance their sense of personal control over their glucose control and, perhaps more broadly, their diabetes,” say Polonsky and colleagues.
However, they found no significant differences between the two groups in hypoglycemic worry – as measured by the worry subscale of the Hypoglycemia Fear Survey II – or in non-diabetes-specific QoL measures, namely the World Health Organization (Five) Well-Being Index and the EQ-5D-5L health status score.
The researchers note that as the study only included adult participants who used MDI, it is not known whether the findings are generalizable to other populations such as teenagers or insulin pump users.
They also caution that “although the noted effect sizes were small/moderate to moderate, improvement within the CGM group itself was modest, and the potential clinical significance is unknown.”
Despite these limitations, they stress that compared with self-monitoring, CGM “contributes to statistically significant improvements in diabetes-specific QOL as well as enhances glycemic control” in type 1 diabetes patients who use MDI.
And the team recommends that “it may be valuable to aid patients in seeing where the device is helping to enhance their QOL, not just improving their glycemic control” to encourage ongoing use of CGM.
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