medwireNews: People with high diabetes distress achieve reductions in glycated hemoglobin (HbA1c) and the need for emergency care for acute diabetes complications after starting on intermittently scanned continuous glucose monitoring (isCGM), report researchers.
The data presented at the 16th ATTD conference in Berlin, Germany, come from the Association of British Clinical Diabetologists nationwide audit at a time before isCGM was routinely available for all adults with type 1 diabetes in England and Wales but people could receive the system for specific indications, including psychosocial.
Harshal Deshmukh (University of Hull, UK) and co-researchers identified 1314 people with psychosocial indications for isCGM from among 17,036 people with type 1 diabetes in the audit, and follow-up data spanning an average of 6 months was available for 327 of these.
This subgroup was slightly younger than the overall cohort, with a significantly shorter duration of diabetes, and a significantly lower rate of insulin pump use. Of note, these people also had significantly higher average baseline HbA1c (80.4 vs 70.2 mmol/mol; 9.5 vs 8.6%) and higher diabetes distress on a two-item scale (3.5 vs 2.8 points).
During follow-up, both of these factors significantly improved, with HbA1c decreasing by an average of 12.4 mmol/mol (3.3%) and diabetes distress from a median score of 4.0 to 2.5.
Moderate or severe diabetes distress was defined as a score of 3 or greater, and the prevalence of this fell from 75% to 38%, reported Deshmukh.
A larger reduction in diabetes distress was significantly associated with higher distress at baseline and spending a greater time in target blood glucose range during follow-up.
“One can extrapolate that the flash glucose monitoring improves time in target, which further improves the diabetes-related distress in this population,” said Deshmukh.
At baseline, hospital admissions for hyperglycemia/diabetic ketoacidosis in people with a psychosocial indication for isCGM were “very, very high,” said the presenter, which he suggested was “contributing to the psychosocial issues in this population.”
There were 40 admissions for this reason in the year prior to starting isCGM, but just four during the follow-up period after initiation.
There were fewer paramedic callouts and hospital admissions for hypoglycemia, but these also reduced markedly after initiation of isCGM, from about 13 to two and from seven to one, respectively.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2023 Springer Healthcare Ltd, part of the Springer Nature Group