Impacto del inicio de la monitorización flash de glucosa en pacientes adultos con diabetes tipo 1
Introduction To achieve the glycemic control objectives, it is key, in type-1 diabetes (DM1) patients, knowing the glycemic status. In this regards, Glucose Flash Monitoring (GFM) has represented a true revolution. Objectives The main objective was to evaluate, in a real-world setting, the change in...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad de Valladolid |
| Repositorio: | UVaDOC. Repositorio Documental de la Universidad de Valladolid |
| OAI Identifier: | oai:uvadoc.uva.es:10324/72390 |
| Acceso en línea: | https://doi.org/10.35376/10324/72390 https://uvadoc.uva.es/handle/10324/72390 |
| Access Level: | acceso abierto |
| Palabra clave: | Diabetes Endocrinology Endocrinología Diabetes mellitus Flash glucose monitoring Monitorización flash glucosa Quality of life Calidad de vida 32 Ciencias Médicas |
| Sumario: | Introduction To achieve the glycemic control objectives, it is key, in type-1 diabetes (DM1) patients, knowing the glycemic status. In this regards, Glucose Flash Monitoring (GFM) has represented a true revolution. Objectives The main objective was to evaluate, in a real-world setting, the change in DM1 patients’ quality of life three months after the GFM onset. The secondary objectives were: 1) to describe the change in metabolic control after the GFM onset, and the degree of metabolic control achieved; 2) to analyze the relationship between the time-in-range and other glycemic parameters and variables; 3) to evaluate the association between the HbA1c and the Glucose Management Indicator (GMI); and 4) to determine the impact of GFM on hypoglycemia and its perception. Material and methods Observational analytic study with prospective cohort design in patients with DM1 that started GFM between June 2019 and April 2020. The quality of life was assessed by instruments adapted and validated to the Spanish language, that included the Diabetes Treatment Satisfaction Questionnaire (EsDTSQ), Diabetes Quality of Life (EsDQOL), and the Distress Diabetes Scale (EsDDS). A series of demographic, clinical and related to glycemic control variables and parameters were collected. Patients were evaluated at baseline, prior to the GFM, and after using GFM for three months. In between, patients received three sessions of diabetes education and care. In addition, multivariable regression models were created to evaluate which variables were associated to a different score in the quality of life scales or a different time in range. The statistical analysis was done with the Statistical Package for Social Sciences, version 26 (SPSS 26.0 IBM Corp, Armonk, IL). Results During the study period 114 patients were included. Sixty-four (56.1%) were male, with a median age of 36 [27-48] years and a mean duration of diabetes disease of 18.7 (11.5) years. Continuous subcutaneous insulin infusion was used by 24.6%. Three months after GFM onset a statistically significant improvement was observed in the treatment satisfaction scales (EsDTSQ (22 [15.5-27] versus (vs.) 25 [22-28]; p<0.001) and quality of life (EsDQOL (88 [74-104] vs. 84 [70-101]; p=0.017), but not in diabetes-related distress (EsDDS). There was a statistically significant reduction in HbA1c after three months (7.8 (1.3) vs. 7.4 (1.1); p< 0.001), in the variation coefficient (41 [37-46] vs. 40 [36-44.3]; p= 0.049) and in the number of hypoglycemia events (14 (9) vs. 11.5 (7); p< 0.001). There was a statistically significant increase in the mean glycemia (162.5 [142-185] vs. 166.5 [147-188.5]; p=0.035) and in the percentage of time in hyperglycemia (37.1 (16.3) vs. 39.8 (16.9); p= 0.016). Conclusion In DM1 patients, the onset of GFM along with a structured diabetes education program was associated with a higher treatment satisfaction and better quality of life, while the differences in the Diabetes Distress Scale did not achieve statistical signification. An improvement in HbA1c was observed, and the number of hypoglycemia events were statistically reduced after the GFM use. |
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