Patient-reported outcome measures in type 1 diabetes outpatient care

Background: Patient-reported outcome measures (PROMs) assess how individuals perceive the disease and its impact on quality of life, representing an important complement to the metabolic evaluation in type 1 diabetes mellitus (T1DM). This study aimed to assess the PROMs and their association with metabolic control.

A cross-sectional study of adults with T1DM was conducted in the outpatient Endocrinology department between October 2022 and May 2023. Clinical, demographic, and continuous glucose monitoring (CGM) data were collected. Three PROMs were applied: the diabetes psychological adjustment scale (ATT18), the World Health Organization well-being index (WHO-5), and the patient health questionnaire (PHQ-9). Descriptive and bivariate statistical analyses were performed.

We included 56 participants, aged 41.2 ± 14.6 years, 58 % female, and 64 % of medium-high socioeconomic class. The disease duration of the cohort was 21 ± 14.6 years, with 44.6 % on continuous subcutaneous insulin infusion (CSII) and 39.3 % presenting microvascular complications. Glycated hemoglobin of the cohort was 8.0 ± 1.4 %, time in range (TIR) 52 ± 22 %, coefficient of variation (CV) 37 ± 8 %, and median time below range (TBR) 2 %. Individuals on CSII had higher TIR (p =0.03). CV was related to TBR (ρ =0.643, p <0.001). The majority had satisfactory psychological adjustment to diabetes (ATT18 ≥60), which correlated directly with WHO-5 (r =0.511, p <0.001) and inversely with depression symptoms (r =-0.676, p <0.001). No relationships were identified between metabolic control and PROMs (p =0.63).

Including PROMs alongside detailed metabolic evaluation allows for individualized decision-making and active patient participation in diabetes management. These results underscore the importance of preventing depression, promoting well-being, and enhancing diabetes psychological adjustment in these patients, aiming to improve their quality of life. HIPPOKRATIA 2024, 28 (1):17-21.