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T1D Exchange was honored to join top scientists, providers, and industry experts in the diabetes space from June 21-24 at the American Diabetes Association’s® (ADA) 84th Scientific Sessions, presenting groundbreaking scientific research.
In total, T1D Exchange had 21 presentations at this year’s conference. This article will cover the seven presentations from our Outcomes Research team.
The T1D Exchange Outcomes Research team presented study findings including four oral and three poster presentations covering topics from diabetes distress to GLP-1 use. Below, we’ve highlighted this T1D Exchange research, which reinforces our mission to improve outcomes for the entire type 1 diabetes (T1D) population through driving real-world evidence and collaborative change.
T1D Exchange Outcomes Research Team Oral Presentations:
[265-OR] Understanding patterns of GLP-1/GLP-1 RA use among individuals with Type 1 Diabetes: A T1D Exchange (T1DX) Online Registry Analysis
While the 2024 ADA Standards of Care prioritize GLP-1 therapy use in individuals living with T2D and overweight/obesity, its use in T1D is not as well delineated, regardless of the increased prevalence of overweight and obesity. This study examined self-reported data from the T1D Exchange Online Registry for GLP-1 use in T1D, differentiating by demographics and clinical characteristics.
Results suggest that GLP-1 use in this T1D cohort is low (only 5.8%, or 470 of 8,053 respondents), despite rates of overweight and obesity. Among those prescribed GLP-1 therapy, 67% are taking a semaglutide product. Of note, there is no significant differential in A1C results between GLP-1 users and non-users (6.6% vs. 6.5%), findings do show an increased use of GLP-1 therapy in those with concomitant cardiovascular disease.
Further research on the benefits of GLP-1 use in T1D is needed.
[244-OR] Association of Type 1 Diabetes Duration or Duration of Advanced Technology Utilization with Severe Hypoglycemic Event Frequency
Many adults living with T1D experience severe hypoglycemic events (SHE) or impaired awareness of hypoglycemia (IAH) regardless of using advanced diabetes technology. This study looked at the association years of disease and use of continuous glucose monitoring played in the frequency of SHE.
Participants from the T1D Exchange Registry completed an online survey about their experiences with SHE, IAH, use of CGM, and years living with T1D. Cohorts were created based on SHE frequency over the past year as well as having issues, or not, with IAH.
No significant associations were found between SHE, years since T1D diagnosis (mean of 29), or CGM use (55% were using ≥5 years) in the 1,847 participants. Findings suggest severe hypoglycemia remains a significant risk factor regardless of advanced technology use and years of living with the condition.
[240-OR] Longitudinal Assessment of Glycemia and Severe Hypoglycemia Among Adults with T1D: An Online Survey
This study was focused on the discovery of longitudinal glucose information, including severe hypoglycemic events (SHEs), in people living with T1D, in particular, with those using advanced diabetes technology such as continuous glucose monitoring (CGM) and automated insulin delivery (AID) devices.
T1D Exchange Registry and Online Community participants completed two surveys: one from February to April 2021 and a follow-up survey from April to May 2023. The surveys collected self-reported use of CGM, method of insulin delivery, A1C, impaired awareness of hypoglycemia (IAH), and SHEs.
Regardless of over 90% of respondents using CGM (baseline: 91.8% and follow-up: 94.4%), as well as having increased rates of AID device use (baseline:53% and follow-up: 69%), nearly one-third did not reach A1C target goals, and those experiencing IAH and SHEs did not see improvements.
These longitudinal results highlight the need for further ingenuity and technological advancements in T1D care.
[241-OR] Health-related Quality of Life and Burden of Type 1 Diabetes and Severe Hypoglycemia in Adult Continuous Glucose Monitor Users
This research was targeted at understanding how severe hypoglycemia events (SHE) can reduce health-related quality of life measures while increasing the human and economic burden on individuals living with T1D.
T1D Exchange Registry participants (18 years and older and CGM users) completed an online self-report survey about SHE experiences, impaired awareness of hypoglycemia (IAH), and patient-reported outcome measures. On average, participants were 49.5 years old, living with T1D for 29 years, and reported 1.8 SHEs in the past year.
While there was variability reported in health-related quality of life and other burdens, those experiencing SHEs had the highest burden measures regardless of using advanced diabetes technology. This study highlights the need for focused efforts on individuals who live with severe hypoglycemia.
T1D Exchange Outcomes Research Team Poster Presentations:
[367-P] Clinical Characteristics of Type 1 Diabetes and Severe Hypoglycemia in Adult Continuous Glucose Monitor Users
For this study, researchers were aiming to uncover the demographic and clinical characteristics of adults living with T1D who have severe hypoglycemic events (SHE) or impaired awareness of hypoglycemia (IAH) and utilize continuous glucose monitoring (CGM).
Participants were adults over 18-years-old and T1D Exchange Registry members who use CGM and have been living with T1D ≥5 years. These individuals completed an online survey answering questions about their demographic and clinical experiences, with 1,847 respondents.
The SHE cohort had a longer duration of T1D, lower insulin pump use rates, and higher average A1C results. In addition, those experiencing severe hypoglycemic events were older and more racially diverse, had lower levels of employment and income, and a higher use of Medicaid as their primary insurer.
According to calculated BMIs, researchers found over 60% of all participants (both SHE and IAH cohorts) live with overweight or obesity.
At baseline, study findings suggest that individuals experiencing SHE have the following in common: a higher clinical burden and a lower socioeconomic status. Researchers suggest this indicates a need for more innovative practices to achieve better outcomes in this cohort.
[370-P] Anxiety and Depressive Symptoms of Type 1 Diabetes and Severe Hypoglycemia in Adult Continuous Glucose Monitor Users
This study’s goal was to examine the relationship between severe hypoglycemic events (SHE) and impaired awareness of hypoglycemia (IAH) with rates of depression and anxiety in adults with T1D who use continuous glucose monitoring. T1D Exchange Registry online survey data in adults (≥ 18 years old) for SHE, IAH, and anxiety/depression symptoms (PHQ-4) was utilized to examine this correlation.
Study results showed a higher frequency of anxiety/depression with SHE, but the same did not hold true for IAH, alone. Findings suggest that more research is needed to understand this complex relationship.
[700-P] Recent and Lifetime Experiences with Diabetes Distress in Adults with T1D
Although diabetes distress (DD) measures help to identify when an individual is struggling with T1D, it typically identifies experiences over the past month. Because T1D is a life-long condition, first-hand experiences of DD may vary widely. This study aimed to understand an individual’s qualitative DD experiences by examining current versus lifetime occurrences.
T1D Registry participants completed an online DD survey and two subscales. Then, they were asked about their DD experience in the past year and over time. Findings showed that most participants experienced DD over the past 12 months in relation to diabetes management, but validated measures weren’t as effective at identifying those with more recent DD experiences.
These results highlight the importance of provider/patient discussions on lived experiences in addition to using DD measurement tools.
