Hypoglycaemic treatment adherence and the association with psychological, self-management and glycaemic characteristics in adults with type 1 diabetes.
Pamela Martyn-Nemeth, Reid Birlingmair, Esema Idemudia and 1 others
PMID 31367410WHAT IT FOUND
Nearly half of adults with type 1 diabetes overtreated hypoglycaemia beyond recommended carbohydrate limits.
Those who overtreating had significantly higher stress and depressive mood scores than adherent participants, but no difference in glycaemic control or variability was found.
Key findings
0145% of participants overtreated hypoglycaemia episodes, while 52% adhered to guidelines.
02Participants who overtreated had significantly higher mean stress and depressive mood levels compared to those who adhered to treatment guidelines.
03There were no significant differences in glycaemic control or glycaemic variability between the overtreatment and adherent groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a secondary analysis not originally powered for these specific comparisons, resulting in a small sample size of 31. Participants were young, well-educated, and all used insulin pump therapy, which limits generalisability to the broader type 1 diabetes population. The design was cross-sectional, so it cannot establish whether stress and depression cause overtreatment or vice versa. Self-reported carbohydrate intake and diary entries may be inaccurate.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that overtreatment worsens glycaemic control based on this paper. Although overtreatment is theoretically linked to poor outcomes, this study found no significant difference in A1C or glycaemic variability between those who overtreating and those who adhered to guidelines.