Cyranka Katarzyna, Matejko Bartłomiej, Juza Anna, Kieć-Wilk Beata, Cohen Ohad, Malecki Maciej T, Klupa Tomasz
Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.
University Hospital in Krakow, Krakow, Poland.
Front Endocrinol (Lausanne). 2023 Aug 15;14:1210756. doi: 10.3389/fendo.2023.1210756. eCollection 2023.
To evaluate the effect of a one-year use of an advanced hybrid closed-loop (AHCL) system on the quality of life, level of anxiety, and level of self-efficacy in adults with type 1 diabetes (T1D) previously treated with multiple daily injections (MDI) and naïve to advanced diabetes technology.
A total of 18 participants of a previously published 3-month randomized trial (10 men, 8 women; age 40.9 ± 7.6 years) who were switched directly from MDI/BMG to AHCL completed 12 months of MiniMed 780G™system use (a 3-month randomized trial followed by a 9-month follow-up phase). At month 6 of the study, patients were switched from the sensor GS3 (Continuous Glucose Monitoring) system, powered by Guardian™ Sensor 3) to GS4. Quality of life was assessed using the Polish validated version of the 'QoL-Q Diabetes' questionnaire. The level of anxiety was evaluated with the use of the State-Trait Anxiety Inventory (STAI). Self-efficacy was assessed with the General Self-Efficacy Scale (GSES). Results were obtained at baseline and at the end of the study.
Significant increase in QoL was reported in the global score (p=0.02, Cohen d=0.61) and in as many as 11 out of 23 analyzed areas of life: being physically active (p=0.02, Cohen d = 0.71); feeling well (p<.01, Cohen d = 0.73); feeling in control of my body (p<.01, Cohen d = 0.72); looking good (p<.01, Cohen d = 1.07); working (p<.01, Cohen d = 1.12); sleeping (p=0.01, Cohen d = 0.66); eating as I would like (p<.01, Cohen d = 0.79); looking after or being useful to others (p= 0.02, Cohen d = 0.65); being active with pets/animals (p<.01, Cohen d = 0.95); being spontaneous (p=0.02, Cohen d = 0.67); and doing "normal" things (p=0.02, Cohen d = 0.67). Both state (p=0.04, Cohen d = 0.56) and trait (p=0.02, Cohen d = 0.60) anxiety decreased while the general self-efficacy increased (p=0.03, Cohen d = 0.76). No participant stopped the use of the pump.
Adult patients with T1D previously treated with MDI and naïve to modern technologies experienced significant improvement in their psychological well-being after transitioning to the AHCL system after 12 months of treatment.
评估使用先进混合闭环（AHCL）系统一年对先前接受多次每日注射（MDI）治疗且未使用过先进糖尿病技术的1型糖尿病（T1D）成人患者生活质量、焦虑水平和自我效能水平的影响。
先前一项为期3个月的随机试验中的18名参与者（10名男性，8名女性；年龄40.9±7.6岁）直接从MDI/基础胰岛素治疗转换为AHCL，完成了12个月的美敦力780G™系统使用（3个月随机试验，随后是9个月随访阶段）。在研究的第6个月，患者从由Guardian™传感器3供电的GS3（连续血糖监测）系统转换为GS4。使用波兰语验证版的“QoL-Q糖尿病”问卷评估生活质量。使用状态-特质焦虑量表（STAI）评估焦虑水平。使用一般自我效能量表（GSES）评估自我效能。在基线和研究结束时获得结果。
全球评分（p = 0.02，Cohen d = 0.61）以及23个分析生活领域中的11个领域的生活质量显著提高：进行体育活动（p = 0.02，Cohen d = 0.71）；感觉良好（p <.01，Cohen d = 0.73）；感觉能掌控自己的身体（p <.01，Cohen d = 0.72）；看起来不错（p <.01，Cohen d = 1.07）；工作（p <.01，Cohen d = 1.12）；睡眠（p = 0.01，Cohen d = 0.66）；按自己的意愿饮食（p <.01，Cohen d = 0.79）；照顾他人或对他人有用（p = 0.02，Cohen d = 0.65）；与宠物/动物互动（p <.01，Cohen d = 0.95）；自然随性（p = 0.02，Cohen d = 0.67）；做“正常”的事情（p = 0.02，Cohen d = 0.67）。状态焦虑（p = 0.04，Cohen d = 0.56）和特质焦虑（p = 0.02，Cohen d = 0.60）均降低，而一般自我效能增加（p = 0.03，Cohen d = 0.76）。没有参与者停止使用泵。
先前接受MDI治疗且未接触过现代技术的T1D成年患者在接受12个月治疗后转换为AHCL系统后，心理健康状况有显著改善。
