CHICAGO — Despite improvements in technology, nearly 70% of patients with type 1 diabetes never download their glucose data and only 12% ever review the data if they do download, an expert said here.
“Our results show that very few patients are reviewing their glucose and insulin data on their own, in part because of difficulty working with the current tools available, as well as lack of understanding of what to do with the information,” Jenise C. Wong, MD, PhD, from the University of California San Francisco, told Endocrine Today at the joint meeting of the International Congress of Endocrinology and the Endocrine Society. “As diabetes providers, we depend on the data from patients’ diabetes devices to help them evaluate their decisions on food, activity, and insulin doses, and we use the collected data to help make recommendations for the future. Because retrospective review of data is important for optimal diabetes management, we performed this study to get a better idea of how often our patients are doing this on their own.”
Jenise C. Wong
Wong presented data from a cross-sectional survey of 155 patients (median age 29.5 years) with type 1 diabetes on the use of data produced from glucose meters (97%), pumps (68%) and continuous glucose monitoring (CGM, 28%); many subjects used more than one device.
The responses showed that only 31% of patients ever downloaded data from any device; 20% were considered frequent downloaders, doing so at least four times per year; and 12%, or 18 of the 154 who used any device, ever reviewed the downloaded data.
Wong said participants offered various reasons for their lack of data usage: the physician didn’t ask, the patient didn’t know it was an option, the patient lacked the necessary software, labeled themselves as “lazy,” or, were just not interested in utilizing the information.
Wong did show that CGM users were more likely to download and review their data (28% vs. 5% of glucose meter users and 7% of insulin pump users), but the best indicators of frequent reviewers were age (10-year OR=1.5; 95% CI, 1.1-2.1) and length of type 1 diabetes duration (10-year OR=1.7; 95% CI, 1.2-2.4). There was no link between sex, ethnicity, insurance type or education level.
“The older that the participant was and the longer that they had type 1 diabetes, the more likely they were to be a frequent reviewer of their data,” Wong said in a press conference held before her presentation. Yet, after adjusting for confounding factors, “for those who even do frequently review their data, they did not have better glucose control, which we measured by HbA1c.”
Making data easier for patients to obtain, improving device hardware or seamlessly transferring data to the devices such as smartphones, making existing software more user friendly so the patients could better grasp their data implications, are a few ways Wong suggested helping patients improve outcomes, along with physicians assisting in pattern recognition and behavior modification.
“Perhaps better ways of acquiring and presenting the information in more intuitive ways will help, which we are interested in investigating in future studies,” said Wong in an interview. “In the meantime, we as diabetes educators and clinicians can explore novel ways to encourage patients to understand their own health data.” — by Katrina Altersitz
For More Information: Wong JC. Abstract OR26-5. Presented at: The joint meeting of the International Congress of Endocrinology and the Endocrine Society; June 21-24, 2014; Chicago.
Disclosures: Wong reports no relevant financial relationships.