White coat adherence effect on glucose control in adult individuals with diabetes.
Diabetes
Glycemic control
White coat adherence
continuous glucose monitoring (rt/isc CGM)
Journal
Diabetes research and clinical practice
ISSN: 1872-8227
Titre abrégé: Diabetes Res Clin Pract
Pays: Ireland
ID NLM: 8508335
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
28
03
2020
revised:
06
08
2020
accepted:
21
08
2020
pubmed:
29
8
2020
medline:
12
1
2021
entrez:
29
8
2020
Statut:
ppublish
Résumé
White coat adherence (WCA) is defined as an increased adherence to treatment regimens directly before a visit with a healthcare provider. Little is known on the effect of WCA on glucose control in adult patients with diabetes mellitus. The present study is based on 618 CGM-observations of 276 patients with diabetes treated between January 2013 and July 2018. The analysis compares data from the 3 days prior to a visit (p1) with the preceding 25 days (p2). Sensor use was higher during p1 than p2 (92.8 ± 7.3% vs 88.8 ± 7.5%; p < 0.001). Mean glucose [MG] and coefficient of variation [CV] were lower in p1 compared to p2 (MG 163.9 ± 39.2 mg/dL vs 166.9 ± 35.7 mg/dL, p = 0.001; CV 33.5 ± 8.4% vs 36.0 ± 7.0%, p < 0.001; respectively). Time in range (70-180 mg/dL) was higher in p1 than p2 (61.4 ± 21.2% vs 60.0 ± 18.4%, p = 0.002). Sensitivity-analysis showed that WCA effect was mainly detected in patients with HbA This study reveals a WCA effect on pre-visit glucose control in adult patients with diabetes. The effect was most pronounced in patients with moderate to poor glycemic control. In these patients, analysis of CGM data should encompass a minimum of 1 to 2 weeks prior to a consultation.
Sections du résumé
BACKGROUND
BACKGROUND
White coat adherence (WCA) is defined as an increased adherence to treatment regimens directly before a visit with a healthcare provider. Little is known on the effect of WCA on glucose control in adult patients with diabetes mellitus.
METHODS
METHODS
The present study is based on 618 CGM-observations of 276 patients with diabetes treated between January 2013 and July 2018. The analysis compares data from the 3 days prior to a visit (p1) with the preceding 25 days (p2).
RESULTS
RESULTS
Sensor use was higher during p1 than p2 (92.8 ± 7.3% vs 88.8 ± 7.5%; p < 0.001). Mean glucose [MG] and coefficient of variation [CV] were lower in p1 compared to p2 (MG 163.9 ± 39.2 mg/dL vs 166.9 ± 35.7 mg/dL, p = 0.001; CV 33.5 ± 8.4% vs 36.0 ± 7.0%, p < 0.001; respectively). Time in range (70-180 mg/dL) was higher in p1 than p2 (61.4 ± 21.2% vs 60.0 ± 18.4%, p = 0.002). Sensitivity-analysis showed that WCA effect was mainly detected in patients with HbA
CONCLUSION
CONCLUSIONS
This study reveals a WCA effect on pre-visit glucose control in adult patients with diabetes. The effect was most pronounced in patients with moderate to poor glycemic control. In these patients, analysis of CGM data should encompass a minimum of 1 to 2 weeks prior to a consultation.
Identifiants
pubmed: 32858099
pii: S0168-8227(20)30645-8
doi: 10.1016/j.diabres.2020.108392
pii:
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
108392Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declared that there is no conflict of interest.