Endocrine Abstracts

Background: In type 1 diabetes (T1D), quality of life (QoL) and the effectiveness of treatment influence each other. QoL has been associated with glycaemic control assessed by HbA1c in T1D on continuous subcutaneous insulin infusion (CSII), but data on the relationship between Continuous Glucose Monitoring (CGM) metrics and QoL are scarce.

Objectives: To assess QoL and the association between CGM metrics and QoL in T1D on CSII.

Methods: Transversal observational study of adults with T1D on CSII and CGM. Patients with active CGM time <70%, age >65 years and severe unrelated illness were excluded. QoL was assessed by the 34-item ViDa1 questionnaire, between July-December/2021, after its translation and validation. ViDa1 is divided in 4 independent subscales: 2 positively related with QoL (self-care, wellbeing) and 2 negatively related (interference with life [IWL], concern about the illness). Each score is presented in percentage (0-100%).

Results: 56 cases were analysed, with mean age of 34.5±12.6 years, 6.5±5.5 years of CSII and 20.6±10.0 years of diabetes duration. 12.7% had diabetes complications. Mean Glucose Management Indicator (GMI) was 7.2±0.7% (5.8-8.6), Time in range (TIR) 57.7±14.9%, above range (TAR) 35.2±17.1% and bellow range (TBR) 7.1±5.5%, with mean Coefficient of Variation (CV) of 39.8±7.7%. The obtained QoL subscale’s scores were 71.7±17.0% for self-care, 60.6±19.7% for wellbeing, 27.8±20.4% for IWL and 70.2±20.1%. for concern. When questioned, 69.1% reported having overall good QoL. Self-care correlated negatively with GMI (r=-0.42, P=0.001) and TAR (r=-0.40, P=0.003) and positively with TIR (r=0.38, P=0.004), with higher self-care associated with higher TIR. Wellbeing had similar correlations (r=-0.33, P=0.011; r=-0.34, P=0.012 and r=0.34, P=0.012), with higher TIR associated with higher wellbeing. Mean IWL differed significantly across GMI range (P=0.027), scoring 45.5±20.1% for GMI>8% vs 27.7±20.0% and 21.9±18.3% for GMI 7-8% and <7%, respectively. Concern was associated with GMI and TAR, with levels of concern ≤70% showing significantly higher mean GMI (7.3±0.7% vs 6.9±0.6%, P=0.034) and TAR (39.1±9.0% vs 28.5±13.8%, P=0.027). QoL didn’t differ significantly based on TBR or CV. In brief, patients with lower GMI and higher TIR had higher self-care and wellbeing, patients with lower GMI showed lower interference with life and patients with higher GMI and TAR showed higher concern about the illness.

Conclusions: T1D patients on CSII displayed overall satisfactory glycaemic control and QoL. Patients with better glycaemic control displayed better QoL. TBR wasn’t associated with QoL. These results show that QoL may be more influenced by hyperglycaemia than by hypoglycemia.