What Are the Priorities of People With Type 1 Diabetes?

TOPLINE:

A multi-step survey revealed that priorities of people living with type 1 diabetes (T1D) include the ongoing need for research and treatments in the areas of hypoglycaemia prevention, holistic care, and psychological health, along with the need for advancements in technology including artificial intelligence.

METHODOLOGY: 

• A three-survey process was initiated by a steering committee including eight individuals with lived experience/charity representatives and six clinicians.
• A total of 1050 individuals submitted 2937 individual questions to a first survey, and 497 responded to 65 summary questions developed from those, identifying 19 relevant questions.
• A final workshop, held virtually with 27 participants (five endocrinologists, four nurses, two dieticians, two podiatrists, and 13 people living with T1D and their family members), developed and ranked the top 10 priorities.

TAKEAWAY:
The Top Ten Priorities, Ranked

1. Can the use of artificial intelligence or fasting acting insulins help achieve fully closed loop insulin delivery?
2. Is time in range a better predictor of diabetes management and complications compared with A1c?
3. What impact do hormonal phases such as the perimenstrual period and menopause play in glycaemic management and what treatments are most effective for managing glucose levels around these times?
4. What interventions are the most effective for reducing diabetes-related distress and burnout?
5. What are the long-term implications of frequent hypoglycaemia on physical and mental health?
6. What impact does T1D (including frequent low blood sugar) have on memory and cognition in older adults?
7. How can healthcare professionals better take into account the physical, psychological, and social aspects of type 1 diabetes in clinics?
8. How can access to potential therapies like stem cell therapy, transplants, and medications that modify the immune systems be improved so that everyone with type 1 diabetes can be guaranteed access?
9. Why do some people with type 1 diabetes become insulin resistant and does resistance increase with the number of years a person has diabetes and if so, why?
10. Can technology assist to accurately count carbohydrates without having to weigh or measure all foods and drink?

IN PRACTICE:

“The publishing of this top 10 priority should serve to motivate researchers and direct funders towards the most pressing unanswered questions in type 1 diabetes,” the authors wrote.

SOURCE:

Conducted by Christine Newman, MD, of the Institute for Clinical Trials, University of Galway, Ireland, and colleagues, the study was published online in the December 2024 issue of Diabetic Medicine.

LIMITATIONS:

Surveys were available in English only. Steering group was entirely White/UK and Irish. Possible sense of power imbalance when those with lived experience are grouped together with healthcare professionals. Predominant use of social media platforms may have excluded some.

DISCLOSURES:

Funded by a grant from the Health Research Board. Some, but not all, of the authors have industry disclosures.