Therapeutic Advances in Endocrinology and Metabolism (Oct 2024)

Comparing quality of life in traditional face-to-face visits with a hybrid approach of telemedicine with in-person follow-ups in recent users of advanced closed-loop systems: a randomized controlled clinical trial in patients with type 1 diabetes

  • Lía Nattero-Chávez,
  • Esther de La Calle,
  • Edurne Lecumberri-Pascual,
  • Ane Bayona Cebada,
  • Teresa Ruiz Gracia,
  • Alejandra Quintero Tobar,
  • Mar Lorenzo Moñino,
  • Cristina Sánchez Rodríguez,
  • Ana Izquierdo,
  • Héctor F. Escobar-Morreale,
  • Manuel Luque-Ramírez

DOI
https://doi.org/10.1177/20420188241288789
Journal volume & issue
Vol. 15

Abstract

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Background: Our objective was to assess the effect of a hybrid telemedicine approach, in conjunction with face-to-face follow-up, on the quality of life in recent users of an advanced hybrid closed-loop (AHCL) system. Methods: A 1-year open randomized (1:1) clinical trial (ClinicalTrials.gov ID NCT04900636). Participants with type 1 diabetes (T1D) recent users of an AHCL system (Minimed ® 780G) for at least 2–6 months, and ⩾18 years old were eligible. The primary outcome was the change in quality of life measured by the Type 1 Diabetes Life (ViDa1) Questionnaire from baseline to 12 months of hybrid telemedicine plus face-to-face follow-up compared to standard clinical practice. Additionally, impacts on A 1c levels, glucose metrics, advert events, and safety outcomes were assessed. Results: Between January and December 2021, 46 participants were randomly assigned in a 1:1 ratio to either the hybrid telemedicine group ( n = 23) or the control group ( n = 23); 45 participants completed the study, with only 1 from the control group withdrawing before visit 3. At baseline, mean age was 37 ± 15 years and A 1c was 6.9 ± 0.5%. After 12 months, no statistically significant differences in ViDa1 scores between groups were observed. Despite reducing in-person visits in the hybrid follow-up arm, there were no increases in adverse events. Overall, A 1c levels significantly decreased from 6.9 ± 0.5% at baseline to 6.7 ± 0.5% after 12 months ( P = 0.006) without differences between treatment arms, accompanied by reductions in glycemic variability and time below the target range. Conclusion: Our study suggests that there were no significant differences in ViDa1 scores between the two groups at the end of the follow-up. However, among adult patients with T1D who recently adopted an AHCL system, satisfactory glycemic control can be attained through a hybrid follow-up approach, reducing face-to-face visits, without increasing technical complications.