TY - JOUR
T1 - Continuous Glucose Monitoring in Patients with Type 1 Diabetes and Impaired Awareness of Hypoglycemia: Also Effective in Patients with Psychological Distress?
T2 - Also Effective in Patients with Psychological Distress?
AU - van Beers, Cornelis A. J.
AU - de Wit, Maartje
AU - Kleijer, Susanne J.
AU - Geelhoed-Duijvestijn, Petronella H.
AU - DeVries, J. Hans
AU - Kramer, Mark H. H.
AU - Diamant, Michaela
AU - Serné, Erik H.
AU - Snoek, Frank J.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - The aim of this study was to evaluate whether psychological distress modifies the effect of continuous glucose monitoring (CGM) in patients with type 1 diabetes (T1D) and impaired awareness of hypoglycemia. Fifty-two patients with T1D and impaired awareness of hypoglycemia participated in an earlier reported randomized crossover trial with two 16-week intervention periods comparing CGM with self-monitoring of blood glucose (SMBG). During the CGM phase, time spent in euglycemia (4-10mmol/L), the primary outcome, was 9.6% higher compared with the SMBG phase (P <0.0001). Psychological distress was operationalized as low emotional well-being (World Health Organization Well-being Index 5 [WHO-5] <50), high diabetes-related distress (Problem Areas in Diabetes 5 [PAID-5] 8), and/or high fear of hypoglycemia (Hypoglycemia Fear Survey [HFS] Worry > mean HFS Worry score +1 standard deviation). Modifying effects were assessed by analyzing psychological distress scorexinterventioninteraction effects. Results showed that both the low emotional well-being group and normal emotional well-being group had equal glycemic outcomes during the CGM phase. High diabetes distress and elevated fear of hypoglycemia did not result in significant interaction effects for glycemic outcomes. This study demonstrated that CGM is equally effective in terms of glycemic improvements in high versus low distressed patients with T1D and impaired awareness of hypoglycemia
AB - The aim of this study was to evaluate whether psychological distress modifies the effect of continuous glucose monitoring (CGM) in patients with type 1 diabetes (T1D) and impaired awareness of hypoglycemia. Fifty-two patients with T1D and impaired awareness of hypoglycemia participated in an earlier reported randomized crossover trial with two 16-week intervention periods comparing CGM with self-monitoring of blood glucose (SMBG). During the CGM phase, time spent in euglycemia (4-10mmol/L), the primary outcome, was 9.6% higher compared with the SMBG phase (P <0.0001). Psychological distress was operationalized as low emotional well-being (World Health Organization Well-being Index 5 [WHO-5] <50), high diabetes-related distress (Problem Areas in Diabetes 5 [PAID-5] 8), and/or high fear of hypoglycemia (Hypoglycemia Fear Survey [HFS] Worry > mean HFS Worry score +1 standard deviation). Modifying effects were assessed by analyzing psychological distress scorexinterventioninteraction effects. Results showed that both the low emotional well-being group and normal emotional well-being group had equal glycemic outcomes during the CGM phase. High diabetes distress and elevated fear of hypoglycemia did not result in significant interaction effects for glycemic outcomes. This study demonstrated that CGM is equally effective in terms of glycemic improvements in high versus low distressed patients with T1D and impaired awareness of hypoglycemia
KW - Continuous glucose monitoring
KW - Impaired awareness of hypoglycemia
KW - Psychological distress
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85031768285&partnerID=8YFLogxK
U2 - https://doi.org/10.1089/dia.2017.0141
DO - https://doi.org/10.1089/dia.2017.0141
M3 - Article
C2 - 28836833
SN - 1520-9156
VL - 19
SP - 595
EP - 599
JO - Diabetes Technology & Therapeutics
JF - Diabetes Technology & Therapeutics
IS - 10
ER -