Züger, Thomas; Gloor, Manuel; Lehmann, Vera; Melmer, Andreas; Kraus, Mathias; Feuerriegel, Stefan; Laimer, Markus; Stettler, Christoph (2020). White coat adherence effect on glucose control in adult individuals with diabetes. Diabetes research and clinical practice, 168, p. 108392. Elsevier 10.1016/j.diabres.2020.108392
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BACKGROUND
White coat adherence (WCA) is defined as an increased adherence to treatment regimens directly before a visit with a healthcare provider. Little is known on the effect of WCA on glucose control in adult patients with diabetes mellitus.
METHODS
The present study is based on 618 CGM-observations of 276 patients with diabetes treated between January 2013 and July 2018. The analysis compares data from the 3 days prior to a visit (p1) with the preceding 25 days (p2).
RESULTS
Sensor use was higher during p1 than p2 (92.8 ± 7.3% vs 88.8 ± 7.5%; p < 0.001). Mean glucose [MG] and coefficient of variation [CV] were lower in p1 compared to p2 (MG 163.9 ± 39.2 mg/dL vs 166.9 ± 35.7 mg/dL, p = 0.001; CV 33.5 ± 8.4% vs 36.0 ± 7.0%, p < 0.001; respectively). Time in range (70-180 mg/dL) was higher in p1 than p2 (61.4 ± 21.2% vs 60.0 ± 18.4%, p = 0.002). Sensitivity-analysis showed that WCA effect was mainly detected in patients with HbA1c > 7% [53 mmol/mol].
CONCLUSION
This study reveals a WCA effect on pre-visit glucose control in adult patients with diabetes. The effect was most pronounced in patients with moderate to poor glycemic control. In these patients, analysis of CGM data should encompass a minimum of 1 to 2 weeks prior to a consultation.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition |
Graduate School: |
Graduate School for Cellular and Biomedical Sciences (GCB) |
UniBE Contributor: |
Züger, Thomas Johannes, Lehmann, Vera Franziska, Melmer, Andreas, Laimer, Markus, Stettler, Christoph |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0168-8227 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Laura Cavalli |
Date Deposited: |
17 Nov 2020 15:24 |
Last Modified: |
04 Apr 2023 13:13 |
Publisher DOI: |
10.1016/j.diabres.2020.108392 |
PubMed ID: |
32858099 |
Uncontrolled Keywords: |
Diabetes Glycemic control White coat adherence continuous glucose monitoring (rt/isc CGM) |
BORIS DOI: |
10.7892/boris.148218 |
URI: |
https://boris.unibe.ch/id/eprint/148218 |
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