Although this system has shown good glycemic-related outcomes and ease of use, less is known about the well-being and treatment satisfaction of pediatric and young adult users of this system. Other studies of the FSL have reported good precision, decreased glucose variability, increased time in range, and ease of wear. The use of this system has been shown to lead to improvements in behavior and quality of life and to reduce worry in the pediatric and young adult population. A novel option for glucose monitoring is the FreeStyle Libre flash glucose monitoring system (FSL Abbott Diabetes Care Inc., Alameda, CA, USA), which measures interstitial glucose. Recent advances in diabetic technology may help to address some of these concerns. Concerns about managing diabetes in public and the visibility of treatment devices can also impede treatment adherence. In fact, a review of 14 studies found that about one-third of youths and adolescents with type 1 diabetes reported anxiety symptoms that could contribute to poor glycemic control. Studies have shown that children to young adults can experience diabetes distress or anxiety, which in turn can lead to missed boluses, increased HbA1c, less glycemic control, and self-management issues. Mental well-being and quality of life can also be affected by type 1 diabetes. Fear of hypoglycemia has implications for treatment adherence, while prolonged hyperglycemia can lead to long-term multi-organ complications such as neuropathy, nephropathy, vascular and cardiac complications, and retinopathy. An inability to control glycemic levels in the pediatric age group can lead to future health and treatment issues. Some obstacles include unpredictable food intake, physical activities, fear of needles, increased sensitivity to short-acting insulin, and being asymptomatic or unable to convey a hypoglycemic or hyperglycemic status. Treatment of diabetes in the pediatric population can be challenging for a myriad of reasons. The article processing charges were funded by Abbott Diabetes Care. No funding or sponsorship was received for this study. Use of the FSL along with IP or MDI led to higher treatment satisfaction and a greater sense of mental well-being compared with the baseline conventional finger-pricking method. For the WHO-5 questionnaire, the overall well-being percentage score improved from 45.1% at baseline to 93.6% at 12 weeks ( p < 0.001). The overall score for the DTSQ improved from a mean (SD) of 14.4 ± 6.5 at baseline to 32.1 ± 1.8 at 12 weeks.
ResultsĪs compared with the baseline, positive differences were found after 12 weeks of FSL use for all of the items in the DTSQ ( p < 0.001) and the WHO-5 questionnaire ( p < 0.001). At baseline and 12 weeks, a trained interviewer administered the Arabic version of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the WHO-5 Well-Being Index (WHO-5) (1998 version) questionnaire. At the baseline visit, FSL sensors were placed on each participant by a trained diabetes educator. Study participants (aged 14–21 years) were treated for type 1 diabetes with an insulin pump (IP) ( n = 10) or multiple dose injections (MDI) ( n = 23), and used the conventional finger-pricking method for glucose self-testing. MethodsĪ 12-week prospective study was conducted from January 2018 to May 2018 at the Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. This study assessed the treatment satisfaction and sense of well-being attained when patients with type 1 diabetes use the FreeStyle Libre flash glucose monitoring system (FSL Abbott Diabetes Care, Inc., Alameda, CA, USA).