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Metas de Enfermería

Metas de Enfermería

SEPTIEMBRE 2023 N° 7 Volumen 26

Flash monitoring in patients with type 1 diabetes mellitus: treatment adherence, complications and clinical parameters

Section: Originals

How to quote

Cervantes-Torres L, Romero-Blanco C. Monitorización flash en pacientes con diabetes mellitus tipo 1: adherencia, complicaciones y parámetros clínicos. Metas Enferm sep 2023; 26(7):16-23. Doi: https://doi.org/10.35667/MetasEnf.2023.26.1003082140

Authors

Laura Cervantes-Torres1, Cristina Romero-Blanco2

Position

1Enfermera Especialista en Familiar y Comunitaria. Gerencia de Atención Integrada de Manzanares SESCAM (Servicio de Salud de Castilla-La Mancha). España2Doctora en Ciencias del Deporte. Facultad de Enfermería de la Universidad de Castilla-La Mancha. Ciudad Real (España)

Contact address

Laura Cervantes-Torres. Facultad de Enfermería de Ciudad Real. Universidad de Castilla-La Mancha. Avda. Camilo José Cela, 14. 13071 Ciudad Real (Españ

Contact email: lauracervantestorres@gmail.com

Abstract

Objectives: to describe the sociodemographic and clinical profile of persons with Type 1 Diabetes Mellitus (T1D), as well as the use of the FreeStyle Libre (FL) flash monitoring device in those who had paid for it out of their own pocket, and to analyse the differences (lab test parameters, disease complications and treatment adherence) vs. T1D patients using traditional glycemic monitoring through finger prick.
Method: a descriptive cross-sectional study in 206 patients with T1D from a health area in the Castilla-La Mancha region. Study variables: to have a FL device purchased out of pocket, sociodemographic and clinical variables (including lab test parameters) and the validated Self Care Inventory Revised (SCI-R) questionnaire. Univariate and bivariate analyses were conducted, as well as multivariate logistical regression analysis (dependent variable: to have purchased the FL out of pocket).
Results: the multivariate analysis showed that not having the FL device was more likely among those with primary education / no education (OR 4.86 (CI95%: 1.03-22.88); Reference (Ref): secondary / university education, dyslipidemias (OR 3.18 (CI95% 1.39-7.26); Ref: no dyslipidemia, 6 or more hypoglycaemias/ week (OR 3.21 (CI95%: 1.44-7.16); Ref: less than 4, or more finger pricks/day (OR: 17.56 (CI95%: 6.09-50.64); Ref: less than 4. Both the mean baseline glucose and the HBA1c were lower (p< 0.001) among those who had the device, who also had better scores in the SCI-R questionnaire (p< 0.001).
Conclusion: the use of the glycemic control devices allows better management of TDI complications: a lower number of hyper and hypoglycaemias and finger pricks, and better treatment adherence.

Keywords:

Diabetes Mellitus; type 1; blood glucose self-monitoring; treatment adherence and compliance; hypoglycemia; punctures; glycated hemoglobin A

Versión en Español

Título:

Monitorización flash en pacientes con diabetes mellitus tipo 1: adherencia, complicaciones y parámetros clínicos

Artículo completo no disponible en este idioma / Full article is not available in this language

Bibliography

  1. American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes 2022. Diabetes Care 2021; 45(Supplement_1): S17-38. Doi: https://doi.org/10.2337/dc22-S002
  2. American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes—2018. Diabetes Care [internet]. 2018 [citado 8 ago 2023]; 41(Supplement 1):S55-64. Disponible en: http://care.diabetesjournals.org/lookup/doi/
    10.2337/dc18-S006
  3. Rawshani A, Sattar N, Franzén S, Rawshani A, Hattersley AT, Svensson AM, et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. The Lancet 2018; 392(10146):477-86.
  4. Wołoszyn-Durkiewicz A, Myśliwiec M. The prognostic value of inflammatory and vascular endothelial dysfunction biomarkers in microvascular and macrovascular complications in type 1 diabetes. Pediatr Endocrinol Diabetes Metab 2019; 25(1):28-35.
  5. Mújica-Mota MA, Patel N, Saliba I. Hearing loss in type 1 diabetes: Are we facing another microvascular disease? A meta-analysis. Int J Pediatr Otorhinolaryngol 2018; 113:38-45.
  6. Hasan I, Chowdhury ABMA, Haque MdI, Patterson CC. Changes in glycated hemoglobin, diabetes knowledge, quality of life, and anxiety in children and adolescents with type 1 diabetes attending summer camps: A systematic review and meta-analysis. Pediatr Diabetes 2021; 22(2):124-31.
  7. Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care 2017; 40(12):1631-40.
  8. Leelarathna L, Wilmot EG. Flash forward: a review of flash glucose monitoring. Diabet Med 2018; 35(4):472-82.
  9. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128:40-50.
  10. Sensor FreeStyle Libre - Aparato para Checar la Glucosa [internet]. [citado 8 ago 2023]. Disponible en: https://www.freestyle.abbott/mx-es/sensor.html
  11. Oyágüez I, Merino-Torres JF, Brito M, Bellido V, Cardona-Hernández R, Gómez-Peralta F, et al. Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus. BMJ Open Diabetes Res Care. 2020; 8(1): e001330.
  12. Abulqasim J, Alotaibi F, Al Khalifah RA. Safety and user experience with off-label use of a flash glucose monitor (FreeStyle Libre® 1) among very young children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab JPEM. 2023; 36(2):119-25.
  13. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018; 138:271-81.
  14. Khagram L, Martin CR, Davies MJ, Speight J. Psychometric validation of the Self-Care Inventory-Revised (SCI-R) in UK adults with type 2 diabetes using data from the AT. LANTUS Follow-on study. Health Qual Life Outcomes [internet]. 2013 [citado 8 ago 2023];11(1):24. Disponible en: https://hqlo.biomedcentral.com/articles/10.1186/1477-7525-11-24
  15. Jansà M, Vidal M, Gimenez M, Conget I, Gallindo M, Roca, et al. Psychometric analysis of the Spanish and Catalan versions of the Diabetes Self-Care Inventory-Revised version questionnaire. Patient Prefer Adherence [internet]. 2013 [citado 8 ago 2023]; 997. Disponible en: http://www.dovepress.com/psychometric-analysis-of-the-spanish-and-catalan-versions-of-the-diabe-peer-reviewed-article-PPA
  16. Ramón-Arbués E, Martínez-Abadía B, Gracia-Tabuenca T, Yuste-Gran C, Pellicer-García B, Juárez-Vela R, et al. Prevalence of overweight/obesity and its association with diabetes, hypertension, dyslipidemia and metabolic syndrome: a cross-sectional study of a sample of workers in Aragón, Spain. Nutr Hosp. 2019; 36(1):51-9.
  17. Arrieta F, Pedro-Botet J, Iglesias P, Obaya JC, Montánez L, Maldonado GF, et al. Diabetes mellitus y riesgo cardiovascular: actualización de las recomendaciones del Grupo de Trabajo de Diabetes y Enfermedad Cardiovascular de la Sociedad Española de Diabetes (SED, 2021). Clínica e Investig en Arterioscler [internet]. 2021 [citado 8 ago 2023]; S0214916821000978. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0214916821000978
  18. Abed E, LaBarbera B, Dvorak J, Zhang Y, Beck J, Talsania M. Prevalence of dyslipidemia and factors affecting dyslipidemia in young adults with type 1 diabetes: evaluation of statin prescribing. J Pediatr Endocrinol Metab 2019; 32(4):327-34.
  19. Nwosu BU, Yeasmin S, Ayyoub S, Rupendu S, Villalobos-Ortiz TR, Jasmin G, et al. Continuous glucose monitoring reduces pubertal hyperglycemia of type 1 diabetes. J Pediatr Endocrinol Metab 2020; 33(7):865-72.
  20. Aguilera E, Vázquez F. ¿Dónde queda la glucemia capilar después del estudio IMPACT? Implicaciones de una nueva forma de medir la glucosa en la práctica clínica diaria. Endocrinol Diabetes Nutr 2017; 64(3):125-7.
  21. López-Simarro F, Miravet-Jiménez S, Cols-Sagarra C, Castellote-Petit A. Determinaciones analíticas en el paciente diabético. SEMERGEN - Med Fam 2010; 36(9):513-9
  22. Weykamp C. HbA1c: A Review of Analytical and Clinical Aspects. Ann Lab Med. 2013; 33(6):393-400.
  23. Maiorino MI, Signoriello S, Maio A, Chiodini P, Bellastella G, Scappaticcio L, et al. Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials. Diabetes Care 2020; 43(5):1146-56.
  24. Slattery D, Choudhary P. Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes. Diabetes Technol Ther 2017; 19(S2): S-55-S-61.
  25. Bidonde J, Fagerlund BC, Frønsdal KB, Lund UH, Robberstad B. FreeStyle Libre Flash Glucose Self-Monitoring System: A Single-Technology Assessment [internet]. Oslo: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2017 [citado 8 ago 2023]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK482068/
  26. Haak T, Hanaire H, Ajjan R, Hermanns N, Riveline JP, Rayman G. Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-Treated Type 2 Diabetes: a Multicenter, Open-Label Randomized Controlled Trial. Diabetes Ther 2017; 8(1):55-73.
  27. Vézina-Im LA, Morin CM, Desroches S. Sleep, Diet and Physical Activity Among Adults Living With Type 1 and Type 2 Diabetes. Can J Diabetes. octubre de 2021; 45(7):659-65.
  28. Dehghan-Nayeri N, Ghaffari F, Sadeghi T, Mozaffari N. Effects of Motivational Interviewing on Adherence to Treatment Regimens Among Patients With Type 1 Diabetes: A Systematic Review. Diabetes Spectr 2019; 32(2):112-7.