1 University of California , San Diego, California.
2 Behavioral Diabetes Institute, San Diego, California.
Diabetes Technol Ther. 2016 Oct;18(10):664-670. doi: 10.1089/dia.2016.0239. Epub 2016 Sep 27.
Few recent studies have examined the impact of continuous subcutaneous insulin infusion systems on patient-reported quality of life (QOL). We explored QOL changes resulting from treatment with the Omnipod Insulin Management System (Insulet Corp., Billerica, MA).
One thousand two hundred forty-five adults (>18 years) with type 1 diabetes and current Omnipod users completed an online questionnaire examining perceived changes in QOL and glycemic control since Omnipod initiation. The QOL dimensions included overall well-being (World Health Organization-5, modified to examine changes retrospectively), diabetes distress (Type 1 Diabetes Distress Scale, current distress and a modified retrospective version), and psychosocial impact (two subscales from the Diabetes Technology Impact Measure, perceived control over diabetes, and hypoglycemic safety). Regression analyses examined associations between demographics, key psychological factors, and perceived change in glycemic control with the QOL dimensions.
Broad QOL and clinical benefits associated with Omnipod use were common. The majority reported positive changes in the following: overall well-being (53.5%), perceived control over diabetes (72.5%), hypoglycemic safety (50.6%), and diabetes distress (69.6%). Worsening in any of these areas was uncommon. In addition, 64.2% of patients reported glycemic improvement post-Omnipod initiation, while 35.2% reported a decrease in severe hypoglycemic episodes. Trust in one's Omnipod, perceived improvement in glycemic control, and reductions in severe hypoglycemia independently predicted benefits in all QOL measures (all P < 0.001).
These findings suggest that Omnipod users perceived substantial QOL benefits from the device; benefits are more apparent in those who trust the device and have noted positive changes in glycemic control.
鲜有研究探讨连续皮下胰岛素输注系统对患者报告的生活质量(QOL)的影响。我们探讨了使用 Omnipod 胰岛素管理系统(Insulet 公司,马萨诸塞州比勒瑞卡)治疗后 QOL 的变化。
1245 名年龄大于 18 岁的 1 型糖尿病且正在使用 Omnipod 的成年人完成了一项在线问卷调查,评估自使用 Omnipod 以来 QOL 和血糖控制的变化。QOL 维度包括整体幸福感(世界卫生组织-5,修改后用于回顾性评估)、糖尿病困扰(1 型糖尿病困扰量表,当前困扰和修改后的回顾性版本)和心理社会影响(糖尿病技术影响测量的两个子量表,对糖尿病的感知控制和低血糖安全性)。回归分析考察了人口统计学特征、关键心理因素与血糖控制感知变化与 QOL 维度之间的关系。
使用 Omnipod 带来的广泛 QOL 和临床益处很常见。大多数患者报告在以下方面有积极的变化:整体幸福感(53.5%)、对糖尿病的感知控制(72.5%)、低血糖安全性(50.6%)和糖尿病困扰(69.6%)。这些方面恶化的情况并不常见。此外,64.2%的患者报告在使用 Omnipod 后血糖改善,而 35.2%的患者报告严重低血糖发作减少。对 Omnipod 的信任、血糖控制的改善感知以及严重低血糖的减少可独立预测所有 QOL 指标的获益(均 P<0.001)。
这些发现表明 Omnipod 用户从该设备中获得了实质性的 QOL 益处;在信任设备且血糖控制有明显改善的患者中,益处更为明显。