Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Sustained improvement in diabetes-specific quality of life in adults with long-standing type 1 diabetes and problematic hypoglycaemia: 2-year results from the HypoCOMPaSS study (#30)

Elizabeth Holmes-Truscott 1 2 , Jane Speight 1 2 3 , David Kerr 4 , Daniel Flanagan 5 , Simon R Heller 6 , Mark L Evans 7 , James AM Shaw 8
  1. School of Psychology, Deakin University, Geelong, Victoria, Australia
  2. The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
  3. AHP Research, Hornchurch, Essex, UK
  4. William Sansum Diabetes Centre, Santa Barbara, CA, USA
  5. Peninsula College of Medicine and Dentistry, Plymouth, UK
  6. School of Medicine and Biomedical Science, Sheffield University, Sheffield, UK
  7. Wellcome Trust-MRC Institute of Metabolic Science Metabolic Research Laboratories, University of Cambridge , Cambridge, UK
  8. Institute of Cellular Medicine, Newcastle University, Newcastle, UK

Aims: The HypoCOMPaSS 24-week randomised controlled trial among adults with long-standing type 1 diabetes demonstrated improved awareness and reduction in severe hypoglycaemia following education and support, with no relative benefit of technology: insulin pump vs multiple daily injections (MDI) and real-time continuous glucose monitoring (RT-CGM) vs conventional finger prick monitoring (SMBG). These improvements were sustained at 2 years. We now examine the impact of diabetes and the role of technology on quality of life among HypoCOMPaSS participants before, during the trial and at 2-year follow-up.
Methods: Participants were 96 adults with type 1 diabetes: 64% women, aged 49±12 years, diabetes duration 29±12 years. The novel ‘Diabetes QoL-Q’ was completed at baseline (n=92), 24 weeks (n=84) and 24 months (n=59). It includes 26 items (scored 1-5) reflecting the impact of diabetes on various aspects of life, e.g. family, work, driving, holidays, independence, spontaneity. Repeated measures t-tests and analysis of variance were conducted on Diabetes QoL-Q items and composite score to examine change over time. At 24 weeks and 24 months, independent groups t-tests were used examine differences in scores by insulin and monitoring allocation (MDI vs. insulin pump and RT-CGM vs. SMBG).
Results: At 24 weeks, 19/26 items significantly improved, contributing to an improved Diabetes QoL-Q composite score (p<0.001, Cohen’s d=0.36). There were no significant between-group differences at 24 weeks or 24 months. Improvement in Diabetes QoL-Q scores was sustained at 2-year follow-up.
Conclusions: Education and 24-week support to reduce problematic hypoglycaemia was associated with significant improvement in overall diabetes-specific quality of life at 24 weeks, which was sustained at 2 years. Benefits were observed for most aspects of life and achieved across all groups, indicating no relative benefit of insulin pump over MDI or RT-CGM over conventional monitoring.