940-P: Personalized Diabetes Care Reduces Distress and Improves Treatment Satisfaction in Patients with Breast Cancer

Abstract

In patients with breast cancer (BCa) and diabetes (DM) , diabetes distress (DD) and treatment satisfaction (DTS) can influence cancer management and outcomes, yet there is limited data on how important these factors are in the BCa DM population. In this pilot study we assessed the impact of implementing a personalized DM care model on DD and DTS in patients with BCa. Patients in active treatment or surveillance for BCa who had uncontrolled DM (A1c > 7% or random blood glucose > 200 mg/dL) were included. All participants were offered continuous glucose monitoring (CGM) , virtual care and a dedicated diabetes provider with monthly visits for six months. The primary outcomes were change in DD measured by the Diabetes Distress Survey (DDS) and DTS measured by the Diabetes Treatment Satisfaction Questionnaire (DTSQ) . Questionnaires were conducted at 0, 3 and 6 months and changes were assessed using paired T test. Thirty-one women were enrolled (median age 61) . When each participant was assessed for changes in DD, a significant decrease in mean DD was observed at both 3 (baseline: 2.2 vs. 3 months: 1.8, p=0.004) and 6 months (baseline: 2.4 vs. 6 months: 1.9, p= 0.010) . Participants with high DD, DDS score ≥ 3, N=6 (19%) , had a significant decrease in DD at both 3 (baseline: 3.8 vs. 3 months: 2.7, p=0.016) and 6 months (baseline: 3.8 vs. 6 months: 2.7, p=0.018) . Those with low to moderate DD (DDS <3) showed no difference at either 3 (baseline: 1.7 vs. 3 months: 1.5, p=0.082) or 6 months (baseline: 1.8 vs. 6 months: 1.5, p=0.196) . Additionally, a significant increase in the mean DTSQ score was observed at both 3 (baseline: 20.3 vs. 3 months: 28.7, p<0.001) and 6 months (baseline: 19.9 vs. 6 months: 29.3, p=0.002) . Conclusions: Among women with BCa, diabetes distress is prevalent. Personalized DM care models that emphasize remote management and optimize access are therefore not only acceptable to BCa patients, but also lower DM distress and improve treatment satisfaction. Disclosure J.Harrod: None. Y.M.Cheung: None. K.M.Fowler: n/a. M.E.Hughes: None. L.Min: Research Support; Bristol-Myers Squibb Company, Lilly. S.Tolaney: Consultant; 4D Pharma PLC, AstraZeneca, Athenex, BeyondSpring Pharmaceuticals, Bristol-Myers Squibb Company, Certara, Inc., Chugai Pharmaceutical Co., Ltd., CytomX, Daiichi Sankyo, Eisai Co., Ltd., Eli Lilly and Company, Ellipses Pharmaceuticals, Genentech, Inc., Gilead Sciences, Inc., Kyowa Kirin Co., Ltd., Merck & Co., Inc., Mersana Therapeutics, Novartis AG, Odonate, OncoPep, OncoSec Medical Inc, OncXerna, Pfizer Inc., Puma, Sanofi, Seattle Genetics, Inc., Zentalis, Zymeworks, Research Support; AstraZeneca, Bristol-Myers Squibb Company, Cyclacel, Eisai Co., Ltd., Eli Lilly and Company, Exelixis, Genentech, Inc., Gilead Sciences, Inc., Merck & Co., Inc., Nanostring, Nektar, Novartis AG, Odonate, Pfizer Inc., Sanofi, Seattle Genetics, Inc. M.E.Mcdonnell: Advisory Panel; Everlywell, Inc., Research Support; Lilly, Stock/Shareholder; Abbott Diabetes. Funding Lilly USA, LLC