Rubin Richard R, Peyrot Mark
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1402-10. doi: 10.1177/193229680900300621.
Little is known about how the most advanced technology affects treatment satisfaction and health-related quality of life (HRQOL) in adults with diabetes. This study was designed to assess treatment satisfaction and HRQOL among users of an integrated real-time (RT) continuous glucose monitoring (CGM)/continuous subcutaneous insulin infusion (CSII) system compared with those using self-monitoring of blood glucose (SMBG) with CSII.
Participants were 311 adult respondents to an Internet survey, 162 using RT-CGM/CSII, 149 using SMBG + CSII (median age 43 years; type 1 diabetes 94%; diabetes duration >15 years 61%; median insulin use 15 years). Respondents completed instruments assessing glucose monitoring system and insulin delivery system convenience, interference, burden, glucose control efficacy, cost satisfaction, overall satisfaction, and treatment preference, as well as quality of life (diabetes-related worries, social burden, and psychological well-being). Real-time CGM/CSII users also assessed specific elements of the RT-CGM/CSII system. Group differences were assessed using analysis of covariance controlling for respondent characteristics.
The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their glucose monitoring system's glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend, and significantly worse ratings for interference with daily activities. The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their insulin delivery system's convenience and glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend. Real-time CGM/CSII users gave positive ratings of all system features.
Users of the integrated RT-CGM/CSII system reported more benefits of treatment, higher treatment satisfaction and quality of life, and greater preference for this system than SMBG + CSII users.
对于最先进的技术如何影响成年糖尿病患者的治疗满意度和健康相关生活质量（HRQOL），人们了解甚少。本研究旨在评估使用实时（RT）连续血糖监测（CGM）/持续皮下胰岛素输注（CSII）系统的用户与使用自我血糖监测（SMBG）加CSII的用户相比的治疗满意度和HRQOL。
参与者为311名参与互联网调查的成年受访者，其中162人使用RT-CGM/CSII，149人使用SMBG+CSII（中位年龄43岁；1型糖尿病占94%；糖尿病病程>15年占61%；胰岛素使用中位时间15年）。受访者完成了评估血糖监测系统和胰岛素输送系统的便利性、干扰性、负担、血糖控制效果、成本满意度、总体满意度、治疗偏好以及生活质量（与糖尿病相关的担忧、社会负担和心理健康）的问卷。RT-CGM/CSII用户还评估了RT-CGM/CSII系统的具体要素。使用协方差分析控制受访者特征来评估组间差异。
RT-CGM/CSII组在血糖监测系统的血糖控制效果、总体满意度、更换意愿和推荐意愿方面的评分显著高于SMBG+CSII组，而在对日常活动的干扰方面评分显著更低。RT-CGM/CSII组在胰岛素输送系统的便利性、血糖控制效果、总体满意度、更换意愿和推荐意愿方面的评分显著高于SMBG+CSII组。RT-CGM/CSII用户对所有系统功能都给予了积极评价。
与SMBG+CSII用户相比，综合RT-CGM/CSII系统的用户报告的治疗益处更多、治疗满意度和生活质量更高，且对该系统的偏好更强。
