Associations between clinical and psychosocial factors and HbA1c in adult insulin pump users with type 1 diabetes
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Associations between clinical and psychosocial factors and HbA1c in adult insulin pump users with type 1 diabetes. / Schmidt, Signe; Madsen, Kristoffer Panduro; Pedersen-Bjergaard, Ulrik; Rytter, Karen; Hommel, Eva; Cleal, Bryan; Willaing, Ingrid; Andersen, Henrik Ullits; Nørgaard, Kirsten.
In: Acta Diabetologica, Vol. 60, No. 8, 2023, p. 1089-1097.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Associations between clinical and psychosocial factors and HbA1c in adult insulin pump users with type 1 diabetes
AU - Schmidt, Signe
AU - Madsen, Kristoffer Panduro
AU - Pedersen-Bjergaard, Ulrik
AU - Rytter, Karen
AU - Hommel, Eva
AU - Cleal, Bryan
AU - Willaing, Ingrid
AU - Andersen, Henrik Ullits
AU - Nørgaard, Kirsten
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Aims: Many adults with type 1 diabetes do not achieve recommended glycemic goals despite intensive insulin therapy using insulin pumps. The aim of this study was to explore associations between clinical and psychosocial factors and HbA1c in insulin pump users to identify and prioritize areas for potential intervention. Methods: A questionnaire-based survey covering clinical and psychosocial aspects of life with type 1 diabetes was distributed to all adult (≥ 18 years) insulin pump users in the Capital Region of Denmark. Responses were combined with data from medical records and national registries. Associations with HbA1c were modeled using regression-based machine learning. Results: Of 1,591 invited individuals, 770 (48.4%) responded to the survey. Mean HbA1c among responders was 7.3% (56 mmol/mmol), and 35.6% had an HbA1c < 7.0% (53 mmol/mol). Six factors were significantly associated with HbA1c: diabetes duration (0.006% (0.1 mmol/mol) lower HbA1c per 1-year increase in diabetes duration); education (0.4% (4.3 mmol/mol) lower HbA1c with long higher education vs. primary school); insulin type (0.2% (2.2 mmol/mol) lower HbA1c with ultra-rapid-acting insulin vs. rapid-acting insulin); hypoglycemia awareness status (0.2% (2.2 mmol/mol) lower HbA1c with complete unawareness vs. full awareness); insulin device satisfaction (0.2% (2.7 mmol/mol) lower HbA1c per 1-point increase in Insulin Device Satisfaction Survey score); and diabetes distress (0.3% (3.1 mmol/mol) higher HbA1c per 1-point increase in Type 1 Diabetes Distress Scale score). Conclusions: This study identified several associations between clinical and psychosocial factors and HbA1c that may be considered when developing interventions targeted people with type 1 diabetes.
AB - Aims: Many adults with type 1 diabetes do not achieve recommended glycemic goals despite intensive insulin therapy using insulin pumps. The aim of this study was to explore associations between clinical and psychosocial factors and HbA1c in insulin pump users to identify and prioritize areas for potential intervention. Methods: A questionnaire-based survey covering clinical and psychosocial aspects of life with type 1 diabetes was distributed to all adult (≥ 18 years) insulin pump users in the Capital Region of Denmark. Responses were combined with data from medical records and national registries. Associations with HbA1c were modeled using regression-based machine learning. Results: Of 1,591 invited individuals, 770 (48.4%) responded to the survey. Mean HbA1c among responders was 7.3% (56 mmol/mmol), and 35.6% had an HbA1c < 7.0% (53 mmol/mol). Six factors were significantly associated with HbA1c: diabetes duration (0.006% (0.1 mmol/mol) lower HbA1c per 1-year increase in diabetes duration); education (0.4% (4.3 mmol/mol) lower HbA1c with long higher education vs. primary school); insulin type (0.2% (2.2 mmol/mol) lower HbA1c with ultra-rapid-acting insulin vs. rapid-acting insulin); hypoglycemia awareness status (0.2% (2.2 mmol/mol) lower HbA1c with complete unawareness vs. full awareness); insulin device satisfaction (0.2% (2.7 mmol/mol) lower HbA1c per 1-point increase in Insulin Device Satisfaction Survey score); and diabetes distress (0.3% (3.1 mmol/mol) higher HbA1c per 1-point increase in Type 1 Diabetes Distress Scale score). Conclusions: This study identified several associations between clinical and psychosocial factors and HbA1c that may be considered when developing interventions targeted people with type 1 diabetes.
KW - HbA1c
KW - Insulin pump
KW - Questionnaire
KW - Registries
KW - Type 1 diabetes
U2 - 10.1007/s00592-023-02081-4
DO - 10.1007/s00592-023-02081-4
M3 - Journal article
C2 - 37160785
AN - SCOPUS:85158935037
VL - 60
SP - 1089
EP - 1097
JO - Acta Diabetologica
JF - Acta Diabetologica
SN - 0940-5429
IS - 8
ER -
ID: 355994363