T1D Exchange Registry: Various factors contribute to superior diabetes management

  • August 9, 2013

PHILADELPHIA — Excellent glucose control can be attributed to diabetes management behaviors, insulin pump therapy, higher socio-economic status and less stress, according to data from the Type 1 Diabetes Exchange Clinic Registry presented here.

Elaine M. Massaro, MS, RN, CDE, of Northwestern University’s Feinberg School of Medicine, said that poor diabetes control can increase the risk for ketoacidosis but does not protect against severe hypoglycemia.

“This study indicates that it’s very important for diabetes educators and other health care professionals to provide education for glucose management while adhering to goals and their patients’ daily activity,” Massaro said.

The Type 1 Diabetes Exchange Clinic Registry began enrollment in 2010. As of May 21, 2013, researchers have collected data from 26,080 patients with type 1 diabetes in a clinic registry at one of the 70 sites for the study. Two-thirds of the data came from patient questionnaires and one-third came from registries, according to researchers.

At the start of the study, patients in the excellent control group (n=714) had an HbA1c of <6.5% while the fair/poor control group (n=1,343) had an HbA1c of ≥8.5%.

According to Massaro, patients in the excellent control group were more likely to be older, non-Hispanic white (94% vs. 85%), married (71% vs. 55%), had higher income (59% vs. 36%) and education level (68% vs. 39%), private insurance (81% vs. 70%), normal BMI (53% vs. .67%), excellent self-reported health (59% vs. 20%) and low stress about their diabetes (50% vs. 28%), compared with the fair/poor patient group (P<.001 for each).

Data indicate patients in the excellent control group were more likely to use a pump, self-monitor their blood sugar more than five times per day (58% vs. 23%), test their blood glucose before meal bolus (88% vs. 68%), demonstrate <1 insulin:carbohydrate ratio per day (28% vs. 16%), give insulin bolus before meal (69% vs. 53%) and daytime snacks (43% vs. 33%), never miss an insulin dose (68% vs. 32%), have a lower total daily insulin dose (64% vs. 49%) and a higher ratio of bolus to basal insulin (45% vs. 31%), compared with the fair/poor group (P<.001 for each). – by Samantha Costa

For more information:

Massaro EM. #W20C. Presented at: AADE Annual Meeting and Exhibition; August 7-10; Philadelphia.

Disclosure: Massaro reports no relevant financial disclosures.

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