Background: In type 1 diabetes (T1D), optimal glycaemic control requires intensive self-management to reduce the risk of complications. While routine downloading and review of blood glucose data is part of clinical practice of healthcare providers in an outpatient setting, patients and families are also educated, advised and encouraged to regularly download and review blood glucose data at home in order to make adjustments to insulin dosing for carbohydrate intake and insulin sensitivity factors. In this study, we describe the characteristics between two groups of patients with T1D who routinely download and review their blood glucose data at home compared with a cohort of patients who do not download data at home.
Methods: Patients and their families were considered as ''routine downloaders'' (RD) if their blood glucose device data was downloaded and reviewed at home at least once a month between routine clinic visits which was scheduled every three months. "Non-downloaders" (ND) were defined by those who did not download or review data at home at least once a month, despite being educated on the use of free software and encouraged by healthcare professionals to download. We evaluated demographics, age, duration of diagnosis, socioeconomic deprivation scores, quality of life scores and mean Hb1A1c between RD and ND patients.
Results: 98 patients were included in the study (52 males) with a mean age at diagnosis of 7.4 years (SD±3.8, range 1.1-15.0), mean diabetes duration of 5.2 years (SD± 0.36). The patients' characteristics are reported in Table 1 with 33 patients in the RD group and 65 patients in the ND group. Mean HbA1c (mmol/mol) in the preceding 12 months was significantly better in the RD group compared to ND group (60 vs 66, P=0.03). The ND group had significantly poorer overall deprivations scores, poorer employment and education levels (P<0.05 in all domains). Multivariable logistic regression analysis examining the factors affecting families downloading at home found that overall deprivation was the only independent determinant (P=0.03).
Conclusions: This study shows that social deprivation is an important determinant towards the practice of routinely downloading data at home for families and children with T1D. Healthcare professionals should target deprived areas with further support, education and resources for management of T1D.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology