Endocrine Abstracts

Introduction: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells and requires lifetime insulin treatment. Poor glycemic control may worsen sleep quality in people with diabetes and poor sleep quality may worsen glycemic control by increasing insulin resistance, which could further lead to an overall worsening of the quality of life in diabetes. Technology use in diabetes improves glycemic control and in pediatric populations, it has been shown to improve quality of life and sleep in patients and their caregivers.

Materials and methods: We investigated the changes in sleep quality (Pittsburgh Sleep Quality Index questionnaire) and wellbeing (WHO 5 item questionnaire) in 19 adult people with diabetes (age 47±14 years, 79% women) who transitioned from a less advanced to a more advanced technology. Eleven patients transitioned form multiple daily injections (MDI) to automated insulin delivery (AID), three from sensor augmented pump (SAP) to AID and five from MDI to SAP.

Results: PSQI score improved significantly 3 months after the technological upgrade compared to baseline (5.2±2.8 vs 6.6±3.7, P=0.04), along with a significant improvement in time in range (TIR 73%±11% vs 54%±20%, P=0.00064), time above range (TAR250 6%±6% vs 15%±11%, P=0.009; TAR180-250 18%±8% vs 30%±15%, P=0.001) and HbA1c (7.1%±1.1% vs 7.9%±1.3%, P=0.004). No significant differences were observed in the wellbeing score, time below range (already low at baseline) body weight, blood pressure, renal function or lipid profile.

Conclusions: Technological upgrade results in better glycemic control (lower TAR and higher TIR) and better self-reported sleep quality in adults with T1D.