Breakthrough Diabetes Technology Boosts Quality of Life and Reduces Anxiety in T1 DM

A groundbreaking study has revealed that the introduction of an advanced hybrid closed-loop (AHCL) system for adults with type 1 diabetes (T1D) previously treated with multiple daily injections (MDI) can lead to significant enhancements in their quality of life and a reduction in anxiety levels. This one-year study, based on a previous 3-month randomized trial, showcases the transformative effects of modern diabetes management technology. 

The study was published in the journal Frontiers in Endocrinology on August 15, 2023. 

Iterative innovations in automated (closed loop) insulin delivery have yielded clinically substantial reductions in glycemia, with the ultimate goal of reducing the burden of diabetes treatment at the same time. Previous trials reported on safety and efficacy but not much on its effect on the quality of life. Hence Polish researchers conducted a randomized trial 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. 

The study involved 18 participants who had completed a 3-month randomized trial and were directly transitioned from MDI/BMG to the AHCL system (MiniMed 780G™). The participants underwent 12 months of AHCL system use, comprising a 3-month initial trial period and a subsequent 9-month follow-up phase. At the 6-month mark, participants shifted from the GS3 Continuous Glucose Monitoring (CGM) system to the GS4 model. Key measures included assessments of quality of life using the validated Polish version of the 'QoL-Q Diabetes' questionnaire, anxiety levels utilizing the State-Trait Anxiety Inventory (STAI), and self-efficacy gauged by the General Self-Efficacy Scale (GSES).

The study yielded compelling results that indicated a noteworthy improvement in the overall quality of life score after 12 months of AHCL system usage (p=0.02, Cohen d=0.61). Notably, participants reported improvements in specific aspects of their lives, including physical activity, well-being, body control, appearance, work, sleep, dietary freedom, caregiving, engagement with pets, spontaneity, and the ability to engage in "normal" activities (all with p-values <0.05).

Remarkably, both state and trait anxiety levels showed a decrease (p=0.04 and p=0.02, respectively), reflecting reduced anxiety among participants. Furthermore, general self-efficacy increased (p=0.03), underscoring enhanced confidence in diabetes management with the AHCL system. Notably, none of the participants discontinued the use of the AHCL system, indicating high acceptance and adherence. 

This groundbreaking study presents compelling evidence that the transition to an AHCL system for adults previously managing T1D with MDI can have profound positive effects on their lives. After just 12 months of treatment, individuals reported an improved quality of life, reduced anxiety levels, and increased self-efficacy in diabetes management. This throws a beacon of light on the promising future of diabetes management technology. 

Further reading: Cyranka K, Matejko B, Juza A, Kieć-Wilk B, Cohen O, Malecki MT, Klupa T. Quality of life in the course of a one-year use of an advanced hybrid closed-loop system in adults with type 1 diabetes previously naïve to advanced diabetes technology. Front Endocrinol (Lausanne). 2023 Aug 15;14:1210756. doi: 10.3389/fendo.2023.1210756.