Diabetes Treatment Satisfaction Questionnaire Scores Research Articles

Improved glycaemic control in people with type 2 diabetes initiating or switching to IDegAsp in a real-world setting in China.

To investigate glycaemic control in Chinese adults with type 2 diabetes (T2D) initiating, or switching to insulin degludec/insulin aspart (IDegAsp), a co-formulation of basal, and bolus insulin, in a real-world setting. A 20-week, prospective, single-arm, open-label, non-interventional study was conducted in Chinese adults with T2D initiating, or switching to IDegAsp after anti-hyperglycaemic treatment with oral antidiabetic drugs (OADs), other insulins, or glucagon-like peptide-1 receptor agonists. The primary endpoint was a change in HbA1c from baseline to end of the study; the secondary endpoints included a change in fasting plasma glucose and Diabetes Treatment Satisfaction Questionnaire (DTSQ) score. Significant reductions were observed in mean HbA1c and fasting plasma glucose, among both the overall population (N = 878; -1.27%-points [95% CI: -1.36; -1.19]; p < 0.0001, and -1.61 mmol/L [95% CI: -1.81; -1.41]; p < 0.0001, respectively), and in subgroups switching from OADs only, or basal, or premix insulins ± OADs. The mean total DTSQ score increased from 26.4 (baseline) to 31.6 (end-of-study). No significant, or unexpected tolerability, or safety issues were observed. Significant reductions were observed in incidence rates of non-severe (rate ratio 0.37 [95% CI: 0.24; 0.59]; p < 0.0001) and nocturnal non-severe (rate ratio 0.45 [95% CI: 0.21; 0.94]; p = 0.0326) hypoglycaemic episodes. In a broad, real-world Chinese population of adults with T2D, initiating or switching to IDegAsp was associated with improved glycaemic control and lower rates of hypoglycaemia. The use of IDegAsp could be an effective treatment option for those with suboptimal glycaemic control or therapeutic inertia.

Oral Semaglutide in Type 2 Diabetes: Clinical-Metabolic Outcomes and Quality of Life in Real-World Practice.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a novel class of incretin mimetics for treating type 2 diabetes (T2D). This study evaluated the impact of semaglutide, the first oral GLP-1RA, on glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body composition and anthropometric parameters. Additionally, the effects on cardiovascular risk factors and quality of life (QoL) in T2D patients were assessed. Methods: A prospective observational study with a six-month follow-up was conducted. Clinical parameters, including HbA1c, FPG, anthropometric measurements, blood pressure, cardiovascular risk factors, Diabetes Treatment Satisfaction Questionnaire (DTSQ) responses, and Short Form (36) Health Survey (SF-36) responses, were collected at baseline (T0) and at six months (T1). Results: Sixty-one subjects were enrolled, with there being an average T2D duration of 4.67 ± 3.93 years. Significant decreases were observed in HbA1c (µ = -1.24; SD = 1.33; p < 0.05), FPG (µ = -31.01 mg/dL; SD = 41.71; p < 0.05), body composition and anthropometric parameters (p < 0.05), and cardiovascular risk factors (p < 0.05), with an increase in DTSQ scores (p < 0.05). Conclusions: The administration of 14 mg/day oral semaglutide improved several clinical parameters after six months of treatment. These findings suggest semaglutide is effective in improving glycemic control, weight management, and some cardiovascular risk factors in T2D patients.

Impact of personalized diabetes care on distress and treatment satisfaction in people with breast cancer.

In patients with breast cancer (BCa) and diabetes (DM), diabetes distress (DD) and treatment satisfaction (DTS) can influence BCa management and outcomes. We assessed the impact of implementing a personalized diabetes care model in patients with BCa. Patients in active treatment or surveillance for BCa with an HbA1c > 53 mmol/mol (7%) or random blood glucose >11.1 mmol/L were included. Participants were offered continuous glucose monitoring (CGM), virtual care and a dedicated diabetes provider for 6 months. Primary outcomes included 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. Thirty-one women were enrolled (median age 61, IQR 49.0-69.0). Compared to baseline, the mean DDS score was lower at both 3 months (2.2 vs. 1.8 [n = 27], p = 0.004, SD = 0.70) and 6 months (2.3 vs. 1.8 [n = 23], p = 0.002, SD = 0.70). The mean DTSQ score was higher at 3 months (baseline: 20.5 vs. 3 months: 28.7 [n = 28], p < 0.001, SD = 9.2) and 6 months (baseline: 20.4 vs. 6 months: 30.0 [n = 26], p < 0.001, SD = 9.7). Personalized diabetes care models that emphasize remote management and optimize access for those with BCa may lower DD and improve DTS.

Comparison of Effects of Injectable Semaglutide and Dulaglutide on Oxidative Stress and Glucose Variability in Patients with Type 2 Diabetes Mellitus: A Prospective Preliminary Study.

Recent trials have shown that glucagon-like peptide-1 receptor agonists considerably reduce atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). Oxidative stress, a surrogate marker of cardiovascular risk, is associated with glucose variability. However, to the best of our knowledge, no studies have compared the effects of injectable semaglutide and dulaglutide therapies on oxidative stress and glucose variability assessed via continuous glucose monitoring (CGM). This study aimed to analyze and compare the effects of semaglutide and dulaglutide therapies on oxidative stress and glucose variability as assessed through CGM. This is an open-label, multicenter, randomized, prospective, parallel-group comparison study. Overall, 37 patients with T2DM treated with dulaglutide for at least 12weeks were randomized into two groups: one receiving continuous dulaglutide therapy (n = 19) and one receiving injectable semaglutide therapy (n = 18) groups. The coprimary endpoints were changes in the results of the diacron-reactive oxygen metabolites test, an oxidative stress marker, and CGM-evaluated glucose variability after 24weeks. The secondary endpoint was changes in the Diabetes Treatment Satisfaction Questionnaire (DTSQ) scores. Switching to semaglutide therapy was better than continuous dulaglutide therapy in reducing oxidative stress, glucose variability, and glycated hemoglobin levels. Conversely, continuous dulaglutide therapy was better than semaglutide therapy in terms of DTSQ scores for "Convenience" and "Recommend." Injectable semaglutide therapy may be more effective than dulaglutide therapy in ameliorating oxidative stress and regulating glucose metabolism, including glucose variability, in patients with T2DM, while dulaglutide therapy may be more effective in terms of treatment satisfaction. UMIN-CRT ID: UMIN000042670 (registered 7 December 2020).

SAT123 Treatment Satisfaction And Barriers To Diabetes Care In Patients With Uncontrolled Diabetes Mellitus: A Cross-Sectional Study

Abstract Disclosure: S. Alghrid: None. O. Refadah: None. D. Alharbi: None. N. Aljuhani: None. S. Albalawi: None. S. Aljuhani: None. R. Alaradi: None. A. Yzeed: None. S. Albalawi: None. P. Amirthalingam: None. S.F. Alqifari: None. Background: Diabetes prevalence is reaching 25% in Saudi Arabia. Although diabetes care is provided free of charge, barriers to care and treatment satisfaction among patients remain unknown. Objectives: This study aims to examine diabetes patients’ treatment satisfaction and barriers to care in Saudi Arabia. Methods: We utilized the validated Diabetes Treatment Satisfaction Questionnaire (DTSQ) survey tool to assess diabetes treatment satisfaction among 782 adult Arabic-speaking patients with type 2 diabetes. An additional survey construct was utilized to assess patients’ perspectives on possible barriers to receiving diabetes care. Multivariate linear regression, r Pearson regression, and U Mann-Whitney tests were analyzed. Results: Of the 782 participants interviewed, 55.3% were females. The mean age of the study sample was 59.4 years. The average DTSQs value was 13.5. A strong correlation was observed between DTSQs score and glycemic control, female gender, and utilization of governmental healthcare. Patients of primary healthcare centers had higher satisfaction than tertiary care. Among the barriers to care reported, living in a rural area, transportation, and availability of appointments were the most frequent. Conclusion: Diabetes treatment satisfaction correlated well with glycemic control. The degree of treatment satisfaction in patients with type 2 diabetes was higher in female patients receiving government healthcare. Logistics constituted the most frequent barriers to care reported including living in rural areas, availability of transportation, and appointments. Presentation: Saturday, June 17, 2023

1827-PUB: Multidisciplinary Patient-Centered Care Delivered Remotely Improves Glycemic Outcomes and Patient Reported Outcomes

Lack of access to specialized multidisciplinary teams familiar with advanced technologies for T1D care remains a barrier to achieving glycemic targets and patient-centered goals. Since launching a T1D virtual clinic in 2018, we have treated 123 adults with T1D who had previously received standard care. There was a significant improvement in glycemic indices and in validated and self-originated patient reported outcome measures at 6 and 12 months as compared to baseline (table 1). Mean baseline HbA1c was 8.1%, and this improved to 7.6% and 7.3% at 6 and 12 months respectively (p&amp;lt; 0.001). Average sensor glucose declined by 5.5% over 6 months (p&amp;lt;0.001). While TIR increased significantly by 10.4% over 12 months, TBR decreased. Diabetes Treatment Satisfaction Questionnaire scores improved significantly, as did Diabetes Self-Management Questionnaire scores. According to a 5-point scale survey, there was improved satisfaction with the availability of the physician, nurse and dietitian beyond the appointment time and with the guidance received beyond scheduled visits. Remote care was associated with improved satisfaction regarding saving time and reducing expenses by curtailing office visits. In conclusion, transitioning from a standard T1D care to a virtual clinic is associated with improved glycemic control, higher patient satisfaction and better self-care behaviors. Disclosure N.Minsky: None. A.Tirosh: Advisory Panel; Medtronic, Novo Nordisk, Sanofi, Eli Lilly and Company, Research Support; Medtronic, Sanofi, Speaker's Bureau; Medtronic, Novo Nordisk, Sanofi, Eli Lilly and Company. O.Tamir: Other Relationship; Novo Nordisk. G.Aharon-hananel: Speaker's Bureau; Eli Lilly and Company, Novo Nordisk. A.Jabarin: None. L.Arnon: None. N.Morozov: None. D.Halperin: None. M.Shalom: None. E.Tarshish: None. T.Kolobov: None. Funding European Foundation for the Study of Diabetes (9366); Israel Ministry of Health

786-P: Effects of Switching from Liraglutide or Dulaglutide to Subcutaneous Semaglutide on Metabolic Parameters in Older People with Type 2 Diabetes Mellitus—SWITCH-SEMA1 Subgroup Analysis

Background: Once-weekly treatment with the subcutaneous glucagon-like receptor-1 receptor agonist (GLP-1RA) semaglutide has been reported to have potent beneficial effects on metabolic abnormalities. However, little is known about the usefulness of switching from other GLP-1RAs to semaglutide, especially in older people with type 2 diabetes. Methods: This study is a subgroup analysis of the SWITCH-SEMA1 study, a multicenter, prospective, open-label, parallel-group, randomized controlled study in which people with type 2 diabetes continued liraglutide or dulaglutide therapy or switched to semaglutide for 24 weeks (jRCTs1011200008). One hundred people enrolled in this study were divided into two groups: an aged group consisting of people 65 years or older (n = 49; 72.8 ± 4.4 years old) and a non-aged group (n = 51; 51.2 ± 6.8 years old). The changes of metabolic parameters between the two treatment arms (continuation vs switching to semaglutide) were compared between an aged and a non-aged group. Results: At baseline, BMI, fatty liver index (FLI), C-peptide index (CPI), HOMA2-β, HOMA2-R, eGFR, and triglyceride levels were significantly lower in the aged group (all P &amp;lt; 0.05). After 24 weeks, switching to semaglutide significantly ameliorated HbA1c in both groups (aged: −0.7%, P&amp;lt;0.001; non-aged: −0.7%, P &amp;lt; 0.01). In the aged group, FLI; CPI; HOMA2-β; AST, γ-GTP, and uric acid (UA) levels; and the Diabetes Treatment Satisfaction Questionnaire (DTSQ) score significantly improved after switching to semaglutide (all P &amp;lt; 0.05). The magnitude of changes in BMI and UA levels after switching to semaglutide was greater in the aged group than in the non-aged group (BMI: −1.1 vs. −0.5 kg/m2, P &amp;lt; 0.01; UA: −0.4 vs. −0.1 mg/dL, P &amp;lt;0.05). Conclusions: The effects on metabolic parameters of switching from other GLP-1RAs to once-weekly semaglutide might be greater in aged people than in non-aged people. Disclosure Y.Takahashi: None. H.Nomoto: Speaker's Bureau; Novo Nordisk, Sumitomo Pharma, Co., Ltd. H.Yokoyama: None. A.Miya: None. A.Miyazaki: None. H.Kameda: None. T.Atsumi: Speaker's Bureau; Eli Lilly Japan K.K., Kowa Company, Ltd. A.Nakamura: Research Support; Abbott Japan Co., Ltd., Boehringer Ingelheim Japan, Inc., Daiichi Sankyo, Taisho Pharmaceutical Holdings Co., Ltd., Teijin Pharma Limited, Kowa Company, Ltd., Mitsubishi Tanabe Pharma Corporation. H.Miyoshi: Research Support; Abbott, LifeScan Diabetes Institute, Taisho Pharmaceutical Holdings Co., Ltd., Speaker's Bureau; AstraZeneca, Boehringer Ingelheim Japan, Inc., Eli Lilly Japan K.K., Kowa Company, Ltd., MSD Life Science Foundation, Novo Nordisk, Ono Pharmaceutical Co., Ltd., Sanofi K.K., Mitsubishi Tanabe Pharma Corporation.

Predictors of HbA1c reduction and hypoglycemia in type 2 diabetes mellitus individuals switching from premixed to basal insulin: an exploratory analysis of optimization study

Objective To identify population with type 2 diabetes mellitus (T2DM) who are more likely to benefit from switching to basal insulin (BI) treatment from premixed insulin. Methods This secondary analysis included data from a previously published study (Optimization: NCT00693771) which was a single-arm, multicenter, 16 weeks, phase IV study. The analysis included participants with T2DM inadequately controlled with premixed insulin plus oral hypoglycemic drugs (OADs) who switched to BI plus OADs. Results Among the 297 participants included for analysis, subjects with fasting C-peptide (FCP)>1.2 nmol/L group showed a trend for greater reduction in HbA1c [Least square mean difference (LSMD), −0.59; 95% confidence interval (CI), −0.98 to −0.21; p = 0.003] and FPG (LSMD, −1.36; 95% CI, −2.20 to −0.53; p = 0.002) than those with FCP ≤ 0.4 nmol/L. The baseline insulin glargine 100 U/mL (Gla-100) dose increased significantly in 0.4 to ≤ 1.2 nmol/L group with LS mean difference (SE) of 0.16 (0.01) U/kg/day (p = 0.008) compared to FCP ≤ 0.4 nmol/L group. When combined with Diabetes Treatment Satisfaction Questionnaire (DTSQ) score, participants with a C-peptide level of 0.4 to ≤1.2 nmol/L (OR, 4.05; 95% CI, 1.08 to 15.22; p = 0.039) had significantly higher odds of achieving HbA1c <7%. The number of participants experiencing documented symptomatic hypoglycaemia (≤3.9 mmol/L) was higher in the FCP ≤0.4 nmol/L group compared to those in 0.4 to ≤1.2 nmol/L FCP group at any time of the day (31.6 vs. 17.1%) and during night (00:00 ∼ 05:59) (17.1 vs. 7.5%). Conclusion The findings from this study proposed that FCP is an important biomarker to identify T2DM participants who experience improved glucose control without compromising on hypoglycemia levels during switch from premixed insulin to BI. Participants especially with FCP levels >1.2 nmol/L may respond better in terms of HbA1c reduction without increased hypoglycemia risk compared to those with lower FCP values.

Effects of semaglutide on cardiovascular risk factors and eating behaviors in type 2 diabetes

AimsAim of the present study was to evaluate the impact of once-weekly semaglutide on different end-points indicative of metabolic control, cardiovascular risk, dietary behavior, and treatment satisfaction in T2DM.MethodsThis was a retrospective observational study conducted in a diabetes clinic. Changes in HbA1c, fasting blood glucose (FBG), weight, blood pressure, lipid profile, and number of antihypertensive drugs at 32 weeks (T1) after the first prescription of semaglutide (T0) were analyzed. Furthermore, at T1 patients were asked to fill-in the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Control of Eating Questionnaire (COEQ).ResultsOverall, 104 patients were identified (mean age 63.6 ± 10.4 years, 58.7% men, diabetes duration 12.7 ± 8.7 years). After 32 weeks of treatment with semaglutide, HbA1c levels were reduced by 1.38%, FBG by − 56.53 mg/dl, weight by 6.03 kg. Systolic and diastolic blood pressure, total, HDL-, LDL-, and non –HDL cholesterol, and triglycerides significantly improved. The number of glucose-lowering and antihypertensive drugs also decreased. At T1, DTSQ score was 32.23 ± 1.44, whereas COEQ indicated low levels of hunger and good control of eating.ConclusionsThe study documented benefits of semaglutide on metabolic control and multiple CV risk factors, simplification of therapeutic schemes and high satisfaction with diabetes treatment, and eating behaviors indicative of healthy diet and reduced food intake.

Determinants of insulin treatment satisfaction among type 2 diabetic older adults

IntroductionGlycemic control for elderly diabetics is a challenge. Treatment satisfaction reflects this control.ObjectivesTo determine the factors associated with insulin treatment satisfaction among type 2 diabetic elderly.MethodsA cross-sectional study on 86 type 2 diabetic insulin dependent elderly recruited from the outpatient endocrinology consultation during June and July 2021. We applied the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and geriatric assessment scores.ResultsThree quarters of the patients were satisfied with the insulin therapy. Satisfied patients had significantly less history of hospitalization and more regular follow-up. Diabetic neuropathy medications were significantly less taken by satisfied patients. The number of daily insulin injections was significantly higher in the unsatisfied patients. Diabetic foot was significantly more frequent in unsatisfied patients. Satisfied patients were significantly less depressed, more independent in both basic and instrumental activities of daily living, without memory impairment, in better nutritional status and not falling. Higher DTSQ scores were associated with regular follow up (β 7.92, 95% CI 1.83 to 34.3). Lower DTSQ scores were associated with the history of hospitalization (β 0.12, 95% CI 0.02 to 0.58), the taking of medications for diabetic neuropathy (β 0.07, 95% CI 0.09 to 0.51), the high number of insulin injections (β 0.43, 95% CI 0.19 to 0.97) and the presence of diabetic foot (β 0.17, 95% CI 0.01 to 0.38).ConclusionsRisk factors for patients’ insulin dissatisfaction should be detected early and managed appropriately to improve patients’satisfaction and consequently their well-being.DisclosureNo significant relationships.

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

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 &amp;gt; 7% or random blood glucose &amp;gt; 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 &amp;lt;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&amp;lt;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 &amp; 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 &amp; 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

Impact of flash glucose monitoring on quality of life and glycaemic control parameters in adults with type 1 diabetes mellitus⋆

IntroductionFlash glucose monitoring (FGM) improves some glycaemic control variables and quality of life parameters. ObjectiveOur aim was to evaluate the quality of life and glycaemic control parameters after initiating FGM in patients with type 1 diabetes (DM1) in clinical practice. Material and methodsA prospective observational study in DM1 patients that started using FGM between June 2019 and April 2020. We analysed their scores on the Diabetes Quality of Life (DQOL) questionnaire, Diabetes Distress Scale (DDS), Diabetes Treatment Satisfaction Questionnaire (DTSQ) and glycaemic control parameters at baseline and 3 months after the FGM onset. ResultsWe recruited 114 patients, 56% male, mean age 37.2 (standard deviation, SD 12.4), with 18.7 (SD 11.5) years of DM1, 24.6% of which used continuous subcutaneous insulin infusion. Differences were observed (baseline vs. 3 months) in the DTSQ score (22 [15.5-27] vs. 25 [22-28], P < 0.001) and in the DQOL score (88 [74-104] vs. 84 [70-101], P = 0.017) but not in the DDS score. HbA1c was 7.8% (SD 1.3) vs. 7.4% (SD 1.1) (P < 0.001), without improvement in other glycaemic control variables, except for the mean number of hypoglycaemic events/14 days: 14 (SD 9) at baseline vs. 11.5 (SD 7) at 3 months (P < 0.001). ConclusionsThe initiation of FGM, combined with a structured educational programme, was associated with improvement in quality of life and patient satisfaction in DM1 patients. An improvement in HbA1c and a reduction in the number of hypoglycaemia events was observed, but not in the rest of glycaemic control parameters.

Motivation for Treatment Correlating Most Strongly with an Increase in Satisfaction with Type2 Diabetes Treatment.

IntroductionWe previously reported several factors that cross-sectionally correlate with treatment satisfaction in Japanese patients with type 2 diabetes visiting diabetes clinics. The aim of this study is to identify factors associated with longitudinal changes in treatment satisfaction in patients with type 2 diabetes.MethodsThe study included 649 patients with type 2 diabetes treated with oral glucose-lowering agents who completed the first questionnaire in 2016. The collected data included scores from the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and other parameters regarding diabetes treatment. We analyzed 1-year longitudinal changes in DTSQ scores and investigated factors associated with these changes.ResultsUnivariate linear regression analyses showed that changes in body weight, adherence to diet therapy, adherence to exercise therapy, cost burden, motivation for treatment, regularity of mealtimes, and perceived hypoglycemia correlated with changes in DTSQ scores. On the basis of multiple linear regression analyses, a decrease in hypoglycemia (β ± SE = − 0.394 ± 0.134, p = 0.0034), cost burden (β ± SE = − 0.934 ± 0.389, p = 0.017), and an increase in treatment motivation (β ± SE = 1.621 ± 0.606, p = 0.0077) correlated with DTSQ score increases, suggesting that motivation for treatment had the strongest impact on score increases. Subgroup analyses revealed that an increase in motivation for treatment most significantly correlated with a DTSQ score increase in obese and poor glycemic control groups, regardless of age.ConclusionThis is the first longitudinal study clarifying that an increase in motivation for treatment most strongly correlates with an increase in DTSQ score in patients with type 2 diabetes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-022-01235-x.

Impacto del inicio de la monitorización flash de glucosa en la calidad de vida y en los parámetros de control glucémico de pacientes adultos con diabetes tipo 1

IntroductionFlash glucose monitoring (FGM) improves some glycaemic control variables and quality of life parameters. ObjectiveOur aim was to evaluate the quality of life and glycaemic control parameters after initiating FGM in patients with type 1 diabetes (DM1) in clinical practice. Material and methodsA prospective observational study in DM1 patients that started using FGM between June 2019 and April 2020. We analysed their scores on the Diabetes Quality of Life (DQOL) questionnaire, Diabetes Distress Scale (DDS), Diabetes Treatment Satisfaction Questionnaire (DTSQ) and glycaemic control parameters at baseline and 3months after the FGM onset. ResultsWe recruited 114 patients, 56% male, mean age 37.2 (standard deviation, SD 12.4), with 18.7 (SD 11.5) years of DM1, 24.6% of which used continuous subcutaneous insulin infusion. Differences were observed (baseline vs. 3 months) in the DTSQ score (22 [15.5-27] vs. 25 [22-28], P<0.001) and in the DQOL score (88 [74-104] vs. 84 [70-101], P=0.017) but not in the DDS score. HbA1c was 7.8% (SD 1.3) vs. 7.4% (SD 1.1) (P<0.001), without improvement in other glycaemic control variables, except for the mean number of hypoglycaemic events/14 days: 14 (SD 9) at baseline vs. 11.5 (SD 7) at 3 months (P<0.001). ConclusionsThe initiation of FGM, combined with a structured educational programme, was associated with improvement in quality of life and patient satisfaction in DM1 patients. An improvement in HbA1c and a reduction in the number of hypoglycaemia events was observed, but not in the rest of glycaemic control parameters.

A sensor augmented pump may improve awareness of hypoglycemia and quality of life in Japanese patients with type 1 diabetes mellitus.

Sensor-augmented pump (SAP) therapy reportedly improves glycemic control and quality of life. However, there is limited information on changes in awareness of hypoglycemia and quality of life (QOL) after starting SAP therapy in Japanese patients with type 1 diabetes. The aim of this study was to evaluate glycemic control, awareness of hypoglycemia, and QOL after initiation of SAP therapy in these patients. The study included 20 patients with type 1 diabetes who started SAP therapy. HbA1c levels, values derived from continuous glucose monitoring [including percentages of time in target range (70-180mg/dL), time below range (< 70mg/dL), and time above range (> 180mg/dL)], the Diabetes Treatment Satisfaction Questionnaire score, and the Clarke score were compared between baseline and after 3 and 6months of SAP therapy. There was a significant decrease in HbA1c at 3 and 6months after starting on the SAP (p < 0.0001). There was also a significant decrease in time above range (> 180mg/dL) at the two time points (p = 0.0069 and p = 0.0042, respectively). There was no significant change in time below range (< 70mg/dL). There was a significant reduction in the Clarke score (p = 0.0347 and p = 0.0003, respectively) and a significant increase in the treatment satisfaction score (both p < 0.0001). There was no significant change in any of the three MOS 36-Item Short-Form Health Survey v2 component summary scores. SAP therapy was associated with improvement of glycemic control, mainly by reducing hyperglycemia, and patients' satisfaction with treatment.

Effects of omarigliptin on glucose variability and oxidative stress in type 2 diabetes patients: A prospective study

AimsTo date, no clinical studies have compared once-weekly dipeptidyl peptidase 4 (DPP-4) inhibitors with once-daily DPP-4 inhibitors in terms of glucose variability (GV) and oxidative stress (OS). MethodsThirty-six patients with type 2 diabetes mellitus (T2DM) treated with once-daily DPP-4 inhibitors for at least 12 weeks were randomized to either continue once-daily DPP-4 inhibitors or receive omarigliptin, a once-weekly DPP-4 inhibitor, for 24 weeks. The primary end points were changes in the diacron-reactive oxygen metabolite (d-ROMs) test, a marker of OS, and GV using flash glucose monitoring. The secondary end point was changes in the diabetes treatment satisfaction questionnaire (DTSQ) scores. ResultsThere were no significant group differences in d-ROMs and DTSQ scores after 24 weeks of treatments. However, omarigliptin was superior to once-daily DPP-4 inhibitors in controlling fasting plasma glucose (FPG) and time in range (TIR). Although FPG and TIR were unchanged at 24 weeks after switching to omarigliptin, these parameters increased in the group receiving maintenance therapy with once-daily DPP-4 inhibitors. No statistically significant changes in hemoglobin A1c were observed between the two groups. ConclusionsOur findings suggest that switching from once-daily DPP-4 inhibitors to omarigliptin may be efficacious for maintaining FPG and TIR in T2DM patients.

Pharmacist led intervention towards management of type 2 diabetes mellitus and assessment of patient satisfaction of care - A prospective, randomized controlled study

BackgroundDiabetes mellitus, a metabolic disorder characterized by hyperglycaemia is due to impaired insulin secretion and deficiency. Though effective current drug therapies are available for diabetes, yet glycaemic maintenance remains a challenge without medication adherence. This necessitates a holistic approach to improve clinical outcomes for a better patient health care. MethodsA prospective, interventional, randomized controlled study was conducted among 97 type 2 diabetic patients for 6 months. The primary outcome measures included patient satisfaction of care assessment by diabetes treatment satisfaction questionnaire (DTSQ) and medication adherence by medication adherence rating scale (MARS). Secondary outcomes included assessment of knowledge, attitude, and perception and laboratory parameters. The collected data was analyzed using paired and unpaired T-test. ResultsOf 97 patients randomized to group A (n = 49) and group B (n = 48), there were 3 and 1 drop-out in group A and B, respectively. The mean age of patients was found to be 56.82 ± 4.06 years. At the 6thmonth follow up, significant improvement of glycaemic parameters was observed in group A vs B. Mean MARS and DTSQ scores also improved in group A vs. B (P-value <0.05). ConclusionPharmacist-provided counselling improves patient compliance, quality of life and satisfaction of care in diabetic patients.

62-LB: The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Psychological and Glycaemic Variables in Children with Type 1 Diabetes: A Randomised Crossover Trial

Background: Continuous glucose monitoring (CGM) can decrease fear of hypoglycaemia (FOH) and improve glycaemic control among those affected by type 1 diabetes (T1D). No studies to date have examined the impact of using Do-It-Yourself Real-Time Continuous Glucose Monitoring (DIY RT-CGM) on psychological and glycaemic outcomes. The primary aim of this study was to investigate the effect of DIY RT-CGM compared to intermittently scanned CGM (isCGM) on parental FOH. Methods: Child-parent dyads were recruited for this multicentre randomised crossover trial. Children with T1D were aged 2-13 years and were current isCGM users. Families had 6 weeks of using DIY RT-CGM with parental remote monitoring (intervention) and 6 weeks of isCGM plus usual diabetes care (control) in a random order with a four-week washout period. FOH was assessed by the hypoglycaemia fear survey. Standard CGM based glycaemic variables were collected via Tidepool. Parental satisfaction was assessed by the diabetes treatment satisfaction questionnaire (DTSQ). Results: The study included 55 child-parent dyads; child mean age 9.1±2.8 years. There was no evidence of an effect on parental FOH, -0.1 (95% CI: -0.3, 0.1, p-value 0.4). Time-in-range (%3.9-10mmol/L) favoured DIY RT-CGM over isCGM (54.3%±13.7 vs. 48.1%±13.6), adjusted mean difference, 5.7% (95% CI 1.8, 9.6, p-value 0.004). There was no evidence of a difference between DIY RT-CGM and isCGM for time spent in hypoglycaemia. Parents reported higher DTSQ scores following DIY RT-CGM compared to isCGM, adjusted mean difference 5.3 (95% CI: 2.3, 8.2, p-value &amp;lt;0.001). Conclusion: The use of DIY RT-CGM versus isCGM did not improve parental FOH, however time in range and parental satisfaction with diabetes treatment were significantly improved, suggesting DIY RT-CGM with remote monitoring may offer families clinically important benefits over isCGM in regards to these aspects of T1D management. Disclosure M. Elbalshy: None. B. J. Wheeler: Research Support; Self; Dexcom, Inc., i-SENS, Inc., Medtronic, Ypsomed Group. S. Styles: None. J. J. Haszard: None. B. Galland: None. H. Crocket: None. C. A. Jefferies: None. E. Wiltshire: None. P. Tomlinson: None. M. De bock: None.

Self-Reported Satisfaction to Treatment, Quality of Life and General Health of Type 2 Diabetes Patients with Inadequate Glycemic Control from North-Eastern Romania.

Type 2 diabetes mellitus (T2DM) undermines health and quality of life (QoL). This cross-sectional study surveyed 138 consenting T2DM patients from North-Eastern Romania with regard to their satisfaction with treatment, diabetes-related impact on QoL, and general health. The Romanian versions of Diabetes Treatment Satisfaction Questionnaire (DTSQ), Audit of Diabetes Dependent Quality of Life (ADDQoL-19), and 36-Item Short Form Health Survey (SF-36) questionnaires were used. Self-reports were analyzed in conjunction with clinical and metabolic profiling. The patients were 57.86 ± 8.82 years old, 49.3% men, treated with oral glucose-lowering drugs, presenting with inadequate glycemic control but without cardiovascular manifestations. The mean DTSQ and ADDQoL scores were 25.46 ± 0.61 and −2.22 ± 1.2, respectively. Freedom to eat, holidays, journeys, leisure, physical health, sex life, freedom to drink, and feelings about the future scored below average. The mean SF-36 physical and mental health scores were 47.78 ± 1.03 and 50.44 ± 1.38, respectively. The mean SF-6D score was 0.59 ± 0.04 (generated retrospectively using SF-36 data). Negative associations were significant between ADDQoL, age (r = −0.16), and body mass index (r = −0.23), p < 0.01. Overall scores did not correlate with diabetes duration (except DTSQ, r = −1.18, p = 0.02) or HbA1c. The results confirm other researchers’ findings in Europe and nearby countries. Our patients seemed satisfied with treatment despite glycemic imbalance and viewed diabetes as a burden on QoL and especially freedom to eat.

Comparison of Patient-Led and Physician-Led Insulin Titration in Japanese Type 2 Diabetes Mellitus Patients Based on Treatment Distress, Satisfaction, and Self-Efficacy: The COMMIT-Patient Study.

IntroductionIn Japan, patient-led insulin titration is rare in type 2 diabetes mellitus (T2DM) patients. Few studies have compared the effects of patient-led versus physician-led insulin titration on patient-reported outcomes in Japanese T2DM patients. This study aimed to compare the effects of patient-led and physician-led insulin titration in Japanese insulin-naïve T2DM patients on safety, glycemic control, and patient-reported outcomes (emotional distress, treatment satisfaction, and self-efficacy).MethodsUltimately, 125 insulin-naïve Japanese T2DM patients were randomly assigned to either a patient-led insulin self-titration group or a physician-led insulin titration group and monitored for 24 weeks. The primary endpoint was a change in emotional distress as measured using the Problem Areas in Diabetes scale (PAID). Secondary endpoints included treatment satisfaction, as measured with the Diabetes Treatment Satisfaction Questionnaire (DTSQ), self-efficacy as measured using the Insulin Therapy Self-Efficacy Scale (ITSS), glycated hemoglobin (HbA1c) levels, fasting plasma glucose levels, body weight, insulin daily dose, and frequency of hypoglycemia.ResultsThere was no significant difference between the groups in PAID and DTSQ scores. The results for the primary endpoint should be interpreted taking account that the sample size for the power calculation was not reached. ITSS scores were significantly higher in the patient-led self-titration group. HbA1c and fasting plasma glucose levels were significantly decreased in both groups, but the decrease was significantly larger in the patient-led self-titration group. Although the insulin daily dose was significantly higher in the patient-led self-titration group, severe hypoglycemia did not occur in either group, and the frequency of hypoglycemia was similar in both groups.ConclusionSelf-measurement of blood glucose and self-titration of insulin enhanced the patients’ self-efficacy without compromising their emotional distress or treatment satisfaction. Also, insulin self-titration was found to be safe and effective; it resulted in better glycemic control without severe hypoglycemia.Trial registrationUniversity Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (registration number: UMIN000020316).Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-020-00995-8.