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Psychosocial Impact of Real-time Continuous Glucose Monitoring (CGM) in Type 1 Diabetes (T1D)
Psychosocial Impact of Real-Time Continuous Glucose Monitoring (CGM) in Type 1 Diabetes (T1D) CGM may improve glycemic cont CGM may improve glycemic control while reducing hypoglycemia, however the psychological impact of CGM remains unclear. To examine associations between CGM use and psychosocial outcomes, we assessed 49 T1D patients (ages 8-40 years) enrolled in a larger, 6-month RCT comparing CGM (n=27) with BG monitoring (BGM, n=22). Surveys were completed by 28 parent-child pairs (15 CGM, 13 BGM) and 21 adults (12 CGM, 9 BGM). At baseline, A1c values were identical in both groups (7.6±0.7%); at 6 months, A1c was 7.3±1.0% in the CGM group and 7.7±0.7% in the BGM group.
Participants completed validated measures of quality of life (QoL) (PedsQL or SF12v2 physical (P) & mental (M) subscales); perceived burden of diabetes (PAID); fear of hypoglycemia (HFS); depressive symptoms (CES-D); and anxiety (STAI-State/Trait) (see Table).
After 6 months, adults in the CGM group reported higher QoL (SF12 M, p=.07), less burden (p<.06), fewer depressive symptoms (p=.1), and less anxiety (p<.01) than adults in the BGM group. Parents of youth in the CGM group reported less fear of hypoglycemia (p=.1) than parents of youth in the BGM group. Youth in the CGM group reported more depressive symptoms (p=.08) than youth in the BGM group.
These pilot data suggest that adults with T1D appear to value opportunities provided by CGM to improve glycemic control and thus they experience significant psychosocial benefit. Parents of youth with T1D appear to recognize the opportunity to reduce hypoglycemia with CGM. Youth with T1D do not appear to derive psychological benefit from CGM, likely related to additional demands placed upon CGM users (calibrations, alarms, etc.). Attention to psychosocial factors and management of patient expectations may facilitate implementation of CGM and improve outcomes.
Authors
M Lori Laffel, KE Pratt, J Aggarwal, LK Volkening, K Milaszewski, J Keady, LM Kuhn
Journal
Diabetes
Therapeutic Area
Other
Center of Excellence
Patient-Centered outcomes
Year
2009
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