Predictors of Diabetes-related Distress (DRD) before and after FreeStyle Libre-1 use: Lessons from Association of British Clinical Diabetologists (ABCD) nationwide study.

Deshmukh, Harshal, Wilmot, Emma G, Gregory, Robert, Barnes, Dennis, Narendran, Parth, Saunders, Simon, Furlong, Niall, Kamaruddin, Shafie, Banatwalla, Rumaisa, Herring, Roselle, Kilvert, Anne, Patmore, Jane, Walton, Chris, Ryder, Robert E J and Sathyapalan, Thozhukat (2021) Predictors of Diabetes-related Distress (DRD) before and after FreeStyle Libre-1 use: Lessons from Association of British Clinical Diabetologists (ABCD) nationwide study. Diabetes, obesity & metabolism. ISSN 1463-1326. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://onlinelibrary.wiley.com/journal/10.1111/(IS...

Abstract

AIM

The objective of this study was to identify the baseline demographic and clinical characteristics associated with Diabetes-related Distress (DRD) and factors associated with improvement in DRD with the use of FreeStyle Libre-1 (FSL) in people living with Type 1 Diabetes (T1D).

METHODS

The study was performed using baseline and follow up data from the ABCD nationwide audit of people with diabetes initiated on the FSL in the United Kingdom. DRD was assessed using the two-item diabetes-related distress score (DDS) (defined as the average of the two-item score ≥3). People living with T1D were categorised into two groups, a high DRD was defined as average DDS greater than or equal to 3 and lower DRD as DDS less than three. We used an unsupervised gradient boosting machine learning model (GBM) to identify the relative influence (RI) of baseline parameters on average DDS score.

RESULTS

The study population consisted of 9,159 patients, 96.6% of which had T1D, with a median age of 45.1 years (IQR=32-56), with 50.1% females with a median baseline BMI of 26.1 (IQR=23.2-29.6) and median duration of diabetes 20 (IQR=11-32) years. The two components of the DDS were significantly correlated (r2=0.73 P<0.0001). Higher DRD was prevalent in 53% (n=4879 of 9159) of people living with T1D at baseline. In the GBM model, the top baseline variables associated with average DDS were baseline HbA1c (RI=51.1), baseline GOLD score (RI=23.3), gender (RI=7.05) and fear of hypoglycaemia (RI=4.96). Follow up data were available for 3312 participants. The top factors associated with improvement in DDS following use of FSL were change in GOLD score (RI=28.2) and change in baseline HbA1c (RI=19.3) CONCLUSIONS: In this large UK cohort of people living with T1D, diabetes distress was prevalent and associated with higher HbA1c, impaired awareness of hypoglycaemia and female gender. Improvement in glycaemic control and hypoglycaemia unawareness with the use of FSL was associated with improvement in DRD in people living with T1D. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WD Diseases and disorders of systemic, metabolic or environmental origin > WD250 Metabolic diseases
Divisions: Ambulatory Care > Diabetes
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 28 Jun 2021 12:31
Last Modified: 28 Jun 2021 12:31
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4455

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