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  • Larsson, Christina R.Linköpings universitet,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia (author)

Suboptimal behaviour and knowledge regarding overnight glycaemia in adults with type 1 diabetes is common

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • 2018-09-04
  • Wiley-Blackwell Publishing Inc.2018
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-151492
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-151492URI
  • https://doi.org/10.1111/imj.13798DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|CSN (Centrala studiestodsnamnden); NHMRC; University of Sydney, Sydney Medical School Foundation
  • BackgroundIn people with type 1 diabetes (T1D), nocturnal hypoglycaemia (NH) can be slept through and can cause seizures, arrhythmias and death. Hypoglycaemia avoidance can induce hyperglycaemia and ketosis. Patient behaviour impacts clinical outcomes and may be changed by education.AimTo develop and utilise a survey to evaluate patient self‐management of overnight glycaemia in adults with T1D.MethodsAdults with T1D attending two Australian tertiary referral diabetes clinics completed a survey about their diabetes self‐management and glycaemic control, including responses to hypothetical pre‐bed blood glucose (BG) levels (4–20 mmol/L). Statistical analyses included t‐tests, Chi square tests and ANOVA with significance considered at P < 0.05.ResultsThere were 205 participants (103 females), with a mean (SD) age of 41 (17) years, T1D duration of 20 (16) years, HbA1c of 7.8(1.4)%, (61.3(8.2) mmol/mol), 38% on insulin pump therapy (CSII) and 36% with impaired hypoglycaemia awareness (IHA). Mean (SD) number of BG tests/day was 5.4 (2.7). Patients set higher BG target levels at bedtime and overnight: 7.5(1.4) and 7.1(1.3) mmol/L, respectively, compared to daytime (6.9(1.0); P < 0.0001 and P = 0.002 respectively). Only 36% of participants reported treating nocturnal hypoglycaemia (NH) with the recommended refined, then complex, carbohydrate. Only 28% of patients made safe choices in all bedtime BG scenarios, with higher rates for CSII users, P = 0.0005. Further education was desired by 32% of respondents, with higher rates in those with (44%) versus without IHA (25%), P = 0.006.ConclusionsMany adults with T1D have suboptimal knowledge and behaviour regarding overnight BG self‐management. A survey, piloted herein, may facilitate the identification of patients who could benefit from further education.

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  • Januszewski, Andrzej S.NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia; Department of Diabetes and Endocrinology, St Vincent’s Hospital Melbourne and University of Melbourne, Melbourne, Victoria, Australia (author)
  • McGrath, Rachel T.Department of Diabetes, Endocrinology and Metabolism, Northern Clinical School, The University of Sydney, Royal North Shore Hospital, Sydney, New South Wales, Australia (author)
  • Ludvigsson, JohnnyLinköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus(Swepub:liu)johlu29 (author)
  • Keech, Anthony C.NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia (author)
  • MacIsaac, Richard J.Department of Diabetes and Endocrinology, St Vincent’s Hospital Melbourne and University of Melbourne, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia (author)
  • Ward, Glenn M.Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia (author)
  • ONeal, David N.NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia; Department of Diabetes and Endocrinology, St Vincent’s Hospital Melbourne and University of Melbourne, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia (author)
  • Fulcher, Gregory R.Department of Diabetes, Endocrinology and Metabolism, Northern Clinical School, The University of Sydney, Royal North Shore Hospital, Sydney, New South Wales, Australia (author)
  • Jenkins, Alicia J.NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia; Department of Diabetes and Endocrinology, St Vincent’s Hospital Melbourne and University of Melbourne, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia (author)
  • Linköpings universitetInstitutionen för klinisk och experimentell medicin (creator_code:org_t)

Related titles

  • In:Internal medicine journal (Print): Wiley-Blackwell Publishing Inc.48:9, s. 1080-10861444-09031445-5994

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