White coat adherence effect on glucose control in adult individuals with diabetes.

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)

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 Goetschi

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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