Details

Autor(en) / Beteiligte

• Foster, Eric D
• Bridges, Nancy D
• Feurer, Irene D
• Eggerman, Thomas L
• Hunsicker, Lawrence G
• Alejandro, Rodolfo

Titel

Improved Health-Related Quality of Life in a Phase 3 Islet Transplantation Trial in Type 1 Diabetes Complicated by Severe Hypoglycemia

Ist Teil von

• Diabetes care, 2018-05, Vol.41 (5), p.1001-1008

Ort / Verlag

United States: American Diabetes Association

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Attaining glycemic targets without severe hypoglycemic events (SHEs) is a challenging treatment goal for patients with type 1 diabetes complicated by impaired awareness of hypoglycemia (IAH). The CIT Consortium Protocol 07 (CIT-07) trial showed islet transplantation to be an effective treatment for subjects with IAH and intractable SHEs. We evaluated health-related quality of life (HRQOL), functional health status, and health utility before and after pancreatic islet transplantation in CIT-07 trial participants. Four surveys, the Diabetes Distress Scale (DDS), the Hypoglycemic Fear Survey (HFS), the Short Form 36 Health Survey (SF-36), and the EuroQoL 5 Dimensions (EQ-5D), were administered repeatedly before and after islet transplantation. Summary statistics and longitudinal modeling were used to describe changes in survey scores from baseline and to characterize change in relation to a minimally important difference (MID) threshold of half an SD. Improvements in condition-specific HRQOL met the MID threshold. Reductions from baseline in the DDS total score and its four DDS subscales (all ≤ 0.0013) and in the HFS total score and its two subscales (all < 0.0001) were observed across all time points. Improvements were observed after both 1 and 2 years for the EQ-5D visual analog scale (both < 0.0001). In CIT-07, 87.5% of the subjects achieved the primary end point of freedom from SHE along with glycemic control (HbA <7% [<53 mmol/mol]) at 1 year post-initial islet transplantation. The same subjects reported consistent, statistically significant, and clinically meaningful improvements in condition-specific HRQOL as well as self-assessments of overall health.