Better glycemic control with isCGM may lead to less diabetes distress
medwireNews: Gaining greater control of blood glucose and hypoglycemia awareness is associated with a reduction in diabetes distress among people who start using the FreeStyle Libre, researchers report.
Two presentations given at the virtual ATTD 2021 conference used data from 9159 participants of the Association of British Clinical Diabetologists’ FreeStyle Libre audit. The audit contained two questions to assess diabetes distress: one about feeling overwhelmed by the demands of diabetes and one about feelings of failure at self-management. Answers could range from “not a problem” to “a very serious problem” and an average score of at least 3 signified increased diabetes distress.
According to this definition, 53% of the audit participants had moderate or high diabetes distress prior to starting intermittently scanned continuous glucose monitoring (isCGM) with the FreeStyle Libre, with 60% scoring 3 or higher on at least one of the questions, reported Emma Wilmot (University Hospitals of Derby and Burton, UK).
She noted, however, that the inclusion criteria for FreeStyle Libre funding include a psychosocial indication, saying: “As such, it is likely that those with diabetes distress are over-represented in this cohort.”
There were three factors significantly associated with diabetes distress, namely high glycated hemoglobin (HbA1c) level prior to starting on isCGM and poor hypoglycemia awareness (determined by Gold score), and, to a lesser extent, female sex.
In the 3312 participants with data from both before and after starting isCGM, the prevalence of moderate or high diabetes distress fell from 50% to 26%, reported Harshal Deshmukh (Hull York Medical School, UK).
Among these people, improvements in HbA1c and Gold score most strongly associated with reduction in diabetes distress, with frequent scans of the FreeStyle Libre having a lesser but still significant association.
Deshmukh cautioned that they had no socioeconomic data, which could have confounded these associations, and he also reiterated the point that the population could have been biased toward people with diabetes distress.
But he added: “Having said that, almost 30% of the people with diabetes living in the UK now have FreeStyle Libre, so it is a large population.”
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