RT info:eu-repo/semantics/doctoralThesis
T1 Impacto del inicio de la monitorización flash de glucosa en pacientes adultos con diabetes tipo 1
A1 Jiménez Sahagún, Rebeca
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Diabetes
K1 Endocrinology
K1 Endocrinología
K1 Diabetes mellitus
K1 Diabetes mellitus
K1 Flash glucose monitoring
K1 Monitorización flash glucosa
K1 Quality of life
K1 Calidad de vida
K1 32 Ciencias Médicas
AB IntroductionTo 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. ObjectivesThe 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 methodsObservational 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). ConclusionIn 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.
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/72390
UL https://uvadoc.uva.es/handle/10324/72390
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 24-dic-2024