A Minority of Patients with Type 1 Diabetes Routinely Downloads and Retrospectively Reviews Device Data

Abstract

Background: In type 1 diabetes (T1D), periodic review of blood glucose and insulin dosing should be performed, but it is not known how often patients review these data on their own. We describe the proportion of patients with T1D who routinely downloaded and reviewed their data at home.Materials and Methods: A cross-sectional survey of 155 adults and 185 caregivers of children with T1D at a single academic institution was performed. “Routine Downloaders” (downloaded four or more times in the past year) were also considered “Routine Reviewers” if they reviewed their data most of the time they downloaded from devices. Logistic regression was used to identify factors associated with being a Routine Reviewer.Results: Only 31% of adults and 56% of caregivers reported ever downloading data from one or more devices, whereas 20% and 40%, respectively, were considered Routine Downloaders. Only 12% of adults and 27% of caregivers were Routine Reviewers. Mean hemoglobin A1c was lower in Routine Reviewers compared with non-Routine Reviewers (7.2±1.0% vs. 8.1±1.6% [P=0.03] in adults and 7.8±1.4% vs. 8.6±1.7% [P=0.001] in children). In adjusted analysis of adults, the odds ratio of being a Routine Reviewer of one or more devices for every 10-year increase in age was 1.5 (95% confidence interval, 1.1, 2.1 [P=0.02]). For every 10 years since diabetes diagnosis, the odds ratio of being a Routine Reviewer was 1.7 (95% confidence interval, 1.2, 2.4 [P=0.01]). For caregivers, there were no statistically significant factors associated with being a Routine Reviewer.Conclusions: A minority of T1D patients routinely downloads and reviews data from their devices on their own. Further research is needed to understand obstacles, provide better education and tools for self-review, and determine if patient self-review is associated with improved glycemic control.

Twelve-Week 24/7 Ambulatory Artificial Pancreas With Weekly Adaptation of Insulin Delivery Settings: Effect on Hemoglobin A1c and Hypoglycemia

“…The insulin delivery settings for patients starting AP may not be optimized. A well-recognized limitation of current diabetes management is the difficulty in obtaining and analyzing the day-to-day data from diabetes devices, where only a minority of patients ever review their data (28). In fact, during the run-in period of other AP studies, with just the addition of CGM and weekly follow-up for structured education and heightened awareness of their glucose control, patients showed significant improvement in HbA 1c over 4 to 6 weeks before use of AP (29).…”

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes technologies

“…It also enables clinicians and diabetes educators to review such data remotely between visits and make more frequent dosing adjustments. Wong et al found that routinely downloading and reviewing glycemic data was associated with a significantly lower HbA1c (7.2% ± 1.0% vs 8.1% ± 1.6%; P = 0.03) . Despite this positive association, they showed that only 31% of adults and 56% of caregivers reported ever downloading data from devices, and even fewer routinely reviewed the downloaded data .…”

“…Wong et al found that routinely downloading and reviewing glycemic data was associated with a significantly lower HbA1c (7.2% AE 1.0% vs 8.1% AE 1.6%; P = 0.03). 278 Despite this positive association, they showed that only 31% of adults and 56% of caregivers reported ever downloading data from devices, and even fewer routinely reviewed the downloaded data. 278 In a commentary to this article, Beck presented previously unpublished data from the T1DX showing that participants reported rarely or never downloading their devices for BGM (75%), CGM (51%), and insulin pumps (59%).…”

The use of mobile technology to facilitate self‐management in adults with type 1 diabetes: A qualitative explorative approach

“…Similarly, in their study aiming to develop an understanding of selfmonitoring of blood glucose in individuals with both type 1 and type 2 diabetes, Fisher, Kohut, Schachner, and Stenger (2011) reported a reduction in the recommended frequency for BG monitoring due to lack of time commitment, whilst participants in the study by Wong, Neistein, Spindler, and Adi (2015) conveyed that a lack of time had an impact on their decision to download and retrospectively review their BG data.…”