Carbohydrate knowledge, lifestyle and insulin: an observational study of their association with glycaemic control in adults with type 1 diabetes

Smythe, Kylie; Saw, Mercy; Mak, May; Wong, Vincent W.

doi:10.1111/jhn.12561

Cited by 8 publications

(11 citation statements)

References 21 publications

(26 reference statements)

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“…Several analyses reported that insulin dose omission or mistiming of doses were associated with higher levels of HbA1c. 27,29,33,37,38,40,45,46,49,52 PwD appear to be aware of the detrimental impact of suboptimal dosing; 65% of European GAPP2 participants recognized that missing basal insulin doses would negatively affect their health. 19 Furthermore, a substantial proportion of PwD indicated that they felt worried or guilty about missing doses.…”

Section: Discussionmentioning

confidence: 99%

“…Missed insulin doses were consistently reported to be associated with higher HbA1c levels in people with T1D. 27,29,33,37,38,45,46 Similarly, in the GAPP2 study in people with T2D, HCPs indicated that missed insulin doses were associated with negative clinical effects, reporting that ~3-4 missed basal insulin doses per month significantly impacted glycemic control. [19][20][21] data are more limited, it was suggested by two studies that missed insulin doses may be negatively associated with health-related quality of life in adolescents with T1D 37 and adults with T2D.…”

Section: Association Between Missed Doses and Clinical Outcomesmentioning

confidence: 99%

“…All studies identified reported various degrees of missed dose behavior, with rates varying considerably on account of differences in reporting methodologies and time ranges, patient population. For example, in one study it was reported that 56.2% of adults missed at least one bolus insulin dose in the last month, 27 another demonstrated that 21.4% missed at least one dose (insulin type not specified) in the last week, 28 and a third study reported that 12% missed at least one bolus dose per day. 29 Key findings from studies in T1D are presented in Table 2.…”

Section: Studies In Type 1 Diabetesmentioning

confidence: 99%

“…Of the included studies, 14 (n=19 publications) reported on reasons for missed and mistimed insulin doses (Table 6). Reasons were multifactorial and commonly included forgetfulness, 16,18,25,27,41,42 disruption to usual routines including traveling, 16,18,41 or that insulin interfered with the performance of usual daily activities. 16,17,24,44 PwD also reported missing or mistiming doses to avoid hypoglycemia or because their usual eating patterns had been disrupted.…”

Section: Reasons For Suboptimal Insulin Usementioning

confidence: 99%

“…16,17,24,44 PwD also reported missing or mistiming doses to avoid hypoglycemia or because their usual eating patterns had been disrupted. 17,[19][20][21]27,41 Participants in the GAPP1 survey noted that regimen complexity was one of the reasons for insulin omission/non-adherence and that it was challenging to take insulin at the same time each day. 16,18 Other factors commonly associated with suboptimal insulin use were being embarrassed or uncomfortable administering doses in public or social situations or that injections were too painful.…”

Section: Reasons For Suboptimal Insulin Usementioning

confidence: 99%

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Missed and Mistimed Insulin Doses in People with Diabetes: A Systematic Literature Review

Robinson

Newson

Liao

et al. 2021

Diabetes Technology & Therapeutics

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Development of coordinated management approaches is important to facilitate self-care in people with diabetes (PwD). Gaining a better understanding of suboptimal insulin use is key in this endeavor. This review aimed, for the first time, to systematically identify and narratively summarize real-world evidence on the extent of suboptimal insulin use (missed and mistimed insulin) in PwD. A systematic literature search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews identified studies reporting on missed and mistimed insulin dosing. From 3305 studies, 37 publications reporting on 30 unique studies that involved 58,617 PwD were included. Studies were conducted across 12 different countries and most employed cross-sectional surveys. Observations regarding missed and mistimed insulin doses were reported in 25 and 10 studies, respectively. PwD reported missing insulin doses, but rates varied due to differences in reporting methods, participant populations, and insulin regimens. The association between missed dosing and glycemic control was evaluated in ten studies in which the authors reported lower glycated hemoglobin (HbA1c) levels in PwD who did not omit insulin. The proportion of PwD reporting mistiming of insulin was in the range of 20-45%, depending on the study; this was associated with higher rates of hypoglycemia and higher HbA1c as reported by study authors. Reasons for suboptimal insulin use were multifactorial, occurring due to disrupted daily routines, social situations, and hypoglycemia avoidance. This review suggests that suboptimal insulin use is widespread and that PwD using insulin may still be struggling with disease management. There is an unmet need for better integrated support in managing the complexities of insulin therapy and for the development of systems (e.g. digital solutions) that empower people to take control of insulin-treated diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Association Between Missed Doses and Clinical Outcomesmentioning

confidence: 99%

Section: Studies In Type 1 Diabetesmentioning

confidence: 99%

Section: Reasons For Suboptimal Insulin Usementioning

confidence: 99%

Section: Reasons For Suboptimal Insulin Usementioning

confidence: 99%

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Missed and Mistimed Insulin Doses in People with Diabetes: A Systematic Literature Review

Robinson

Newson

Liao

et al. 2021

Diabetes Technology & Therapeutics

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Patients’ Preferences for Connected Insulin Pens: A Discrete Choice Experiment Among Patients with Type 1 and Type 2 Diabetes

Seo

Heidenreich²,

Aldalooj³

et al. 2022

Patient

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Background This study quantified how people with diabetes value the unique features of connected insulin pens and related mobile apps, and the underlying reasons for preferring connected versus non-connected insulin pens. Methods A discrete choice experiment (DCE) was conducted in the USA and UK to elicit preferences of adults (≥ 18 years) with type 1 or 2 diabetes for attributes of insulin pens. Attributes included device type, dosing support, glucose monitoring, additional app features, and data sharing. Relative attribute importance (RAI) scores were calculated to capture the relative importance of an attribute. Predicted choice probabilities were obtained to compare different profiles for connected and non-connected insulin pens. ResultsThe DCE was completed by 540 participants (58.9% male; 90.7% Caucasian; mean age, 58.3 years; 69.4% type 2 diabetes). Participants most valued the possibility of using a connected insulin pen with dosing support and automated dose logging (RAI = 39.9%), followed by automatic transfer of glucose levels (RAI = 29.0%), additional features of tracking diet and physical activity (RAI = 14.6%), data sharing (RAI = 13.6%), and device type (RAI = 2.9%). All profiles of connected insulin pens were preferred over a non-connected pen (p < 0.001), and pen profiles with advanced features were preferred over those without (p < 0.001). Preferences differed by age but not diabetes type, country of residence, or insulin regimen. Conclusion People with diabetes in the USA and UK prefer connected over non-connected insulin pens due largely to the availability of automated logging of dose and glucose levels.

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Quelle place de la diabétologie connectée pour les patients en multi-injections d'insuline ?

Guerci¹

2023

Médecine des Maladies Métaboliques

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Carbohydrate knowledge, lifestyle and insulin: an observational study of their association with glycaemic control in adults with type 1 diabetes

Cited by 8 publications

References 21 publications

Missed and Mistimed Insulin Doses in People with Diabetes: A Systematic Literature Review

Missed and Mistimed Insulin Doses in People with Diabetes: A Systematic Literature Review

Patients’ Preferences for Connected Insulin Pens: A Discrete Choice Experiment Among Patients with Type 1 and Type 2 Diabetes

Quelle place de la diabétologie connectée pour les patients en multi-injections d'insuline ?

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