Dataset Information

Marked improvement in HbA_1c following commencement of flash glucose monitoring in people with type 1 diabetes.

ABSTRACT:

Aims/hypothesis

Minimal evidence supports the efficacy of flash monitoring in lowering HbA_1c. We sought to assess the impact of introducing flash monitoring in our centre.

Methods

We undertook a prospective observational study to assess change in HbA_1c in 900 individuals with type 1 diabetes following flash monitoring (comparator group of 518 with no flash monitoring). Secondary outcomes included changes in hypoglycaemia, quality of life, flash monitoring data and hospital admissions.

Results

Those with baseline HbA_1c ?58 mmol/mol (7.5%) achieved a median -7 mmol/mol (interquartile range [IQR] -13 to -1) (0.6% [-1.2 to -0.1]%) change in HbA_1c (p?1c <58 mmol/mol rose from 34.2% to 50.9% (p?1c across a similar timescale (p?=?0.508). Higher HbA_1c (p?1c fall of ?5 mmol/mol (0.5%). More symptomatic (OR 1.9, p?Conclusions/interpretationFlash monitoring is associated with significant improvements in HbA_1c and fewer diabetic ketoacidosis admissions. Higher rates of hypoglycaemia may relate to greater recognition of hitherto unrecognised events. Impact upon quality of life parameters was mixed but overall treatment satisfaction was overwhelmingly positive.

SUBMITTER: Tyndall V

PROVIDER: S-EPMC6647076 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Marked improvement in HbA<sub>1c</sub> following commencement of flash glucose monitoring in people with type 1 diabetes.

Tyndall Victoria V Stimson Roland H RH Zammitt Nicola N NN Ritchie Stuart A SA McKnight John A JA Dover Anna R AR Gibb Fraser W FW

Diabetologia 20190609 8

<h4>Aims/hypothesis</h4>Minimal evidence supports the efficacy of flash monitoring in lowering HbA<sub>1c</sub>. We sought to assess the impact of introducing flash monitoring in our centre.<h4>Methods</h4>We undertook a prospective observational study to assess change in HbA<sub>1c</sub> in 900 individuals with type 1 diabetes following flash monitoring (comparator group of 518 with no flash monitoring). Secondary outcomes included changes in hypoglycaemia, quality of life, flash monitoring dat ...[more]

PMID: 31177314

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Project description:Aims/hypothesisThe aim of the study was to evaluate longitudinal associations between HbA1c levels, diabetes status and subsequent cognitive decline over a 10 year follow-up period.MethodsData from wave 2 (2004-2005) to wave 7 (2014-2015) of the English Longitudinal Study of Ageing (ELSA) were analysed. Cognitive function was assessed at baseline (wave 2) and reassessed every 2 years at waves 3-7. Linear mixed models were used to evaluate longitudinal associations.ResultsThe study comprised 5189 participants (55.1% women, mean age 65.6 ± 9.4 years) with baseline HbA1c levels ranging from 15.9 to 126.3 mmol/mol (3.6-13.7%). The mean follow-up duration was 8.1 ± 2.8 years and the mean number of cognitive assessments was 4.9 ± 1.5. A 1 mmol/mol increment in HbA1c was significantly associated with an increased rate of decline in global cognitive z scores (-0.0009 SD/year, 95% CI -0.0014, -0.0003), memory z scores (-0.0005 SD/year, 95% CI -0.0009, -0.0001) and executive function z scores (-0.0008 SD/year, 95% CI -0.0013, -0.0004) after adjustment for baseline age, sex, total cholesterol, HDL-cholesterol, triacylglycerol, high-sensitivity C-reactive protein, BMI, education, marital status, depressive symptoms, current smoking, alcohol consumption, hypertension, CHD, stroke, chronic lung disease and cancer. Compared with participants with normoglycaemia, the multivariable-adjusted rate of global cognitive decline associated with prediabetes and diabetes was increased by -0.012 SD/year (95% CI -0.022, -0.002) and -0.031 SD/year (95% CI -0.046, -0.015), respectively (p for trend <0.001). Similarly, memory, executive function and orientation z scores showed an increased rate of cognitive decline with diabetes.Conclusions/interpretationSignificant longitudinal associations between HbA1c levels, diabetes status and long-term cognitive decline were observed in this study. Future studies are required to determine the effects of maintaining optimal glucose control on the rate of cognitive decline in people with diabetes.

Dataset Information

Marked improvement in HbA_1c following commencement of flash glucose monitoring in people with type 1 diabetes.

Aims/hypothesis

Methods

Results

Publications

Marked improvement in HbA<sub>1c</sub> following commencement of flash glucose monitoring in people with type 1 diabetes.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Marked improvement in HbA1c following commencement of flash glucose monitoring in people with type 1 diabetes.

Aims/hypothesis

Methods

Results

Publications

Marked improvement in HbA<sub>1c</sub> following commencement of flash glucose monitoring in people with type 1 diabetes.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Marked improvement in HbA_1c following commencement of flash glucose monitoring in people with type 1 diabetes.