Satisfaction with the Use of Different Technologies for Insulin Delivery and Glucose Monitoring Among Adults with Long-Standing Type 1 Diabetes and Problematic Hypoglycemia: 2-Year Follow-Up in the HypoCOMPaSS Randomized Clinical Trial.
Little, Stuart A
Tan, Horn Kai
Shaw, James AM
Diabetes technology & therapeutics
Mary Ann Liebert Inc.
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Speight, J., Holmes-Truscott, E., Little, S. A., Leelarathna, L., Walkinshaw, E., Tan, H. K., Bowes, A., et al. (2019). Satisfaction with the Use of Different Technologies for Insulin Delivery and Glucose Monitoring Among Adults with Long-Standing Type 1 Diabetes and Problematic Hypoglycemia: 2-Year Follow-Up in the HypoCOMPaSS Randomized Clinical Trial.. Diabetes technology & therapeutics, 21 (11), 619-626. https://doi.org/10.1089/dia.2019.0152
In the HypoCOMPaSS trial, adults with long-standing type 1 diabetes and problematic hypoglycaemia were randomised to compare insulin pump (CSII) vs multiple daily injections (MDI) and real-time continuous glucose monitoring (RT-CGM) vs conventional self-monitoring (SMBG). Our aim was to investigate participants’ satisfaction with these technologies at 6-month RCT endpoint and at 2-year follow-up. Methods Participants completed the Insulin Treatment Satisfaction Questionnaire (ITSQ) subscales ‘device delivery’ and ‘hypoglycaemia control’; and Glucose Monitoring Experience Questionnaire (GME-Q), assessing ‘convenience’, ‘effectiveness’, ‘intrusiveness’ and ‘total satisfaction’. We assessed change over time and between group differences by insulin and monitoring modalities. Results Participants (N=96) were: 64% women, aged 49±12 years, diabetes duration 29±12 years. At 6 months, participants reported improvements compared to baseline (all p<0.001) in satisfaction with insulin ‘delivery device’ (r=0.39) and ‘hypoglycaemia control’ (r=0.52), and trends towards significance in perceived ‘effectiveness’ (r=0.42) and ‘intrusiveness’ (r=0.27) of monitoring device (but not ‘convenience’, p=0.139). All improvements were sustained at 2 years. At 6 months, the only difference between arms was that greater satisfaction with insulin ‘delivery device’ was reported in the CSII group compared to MDI (p<0.001, r=0.40). No between-group differences were observed at 2 years. Conclusions Overall, significant improvements in participant satisfaction with diabetes technologies were observed over the 6-month RCT, in all domains except ‘convenience’, maintained at 2 years. While HypoCOMPaSS demonstrated non-inferiority of SMBG versus CGM, and MDI versus CSII in terms of biomedical outcomes, detailed assessments confirm participants’ satisfaction with delivery device was greater in those allocated to CSII than MDI.
Humans, Diabetes Mellitus, Type 1, Hypoglycemia, Insulin, Blood Glucose, Hypoglycemic Agents, Blood Glucose Self-Monitoring, Treatment Outcome, Insulin Infusion Systems, Follow-Up Studies, Adult, Aged, Middle Aged, Patient Satisfaction, Female, Male, Young Adult, Glycated Hemoglobin A
Diabetes UK NIHR
Diabetes UK (via Newcastle University) (RES/0242/7530)
Wellcome Trust (100574/Z/12/Z)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
External DOI: https://doi.org/10.1089/dia.2019.0152
This record's URL: https://www.repository.cam.ac.uk/handle/1810/294423
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