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.