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CGM increases quality of life in poorly controlled type 1 diabetes
Adults with poorly controlled type 1 diabetes reported better quality of life when they were assigned to a continuous glucose monitor compared with self-monitoring of blood glucose, study data show.
William H. Polonsky, PhD, of the Behavioral Diabetes Institute in San Diego, and colleagues evaluated data from the DIAMOND randomized clinical trial in 155 adults with poorly controlled diabetes (mean age, 48 years; 45% women; mean type 1 diabetes duration, 12 years; mean baseline HbA1c, 8.6%) to determine the impact on quality of life of 24 weeks of continuous glucose monitoring (CGM; n = 102) compared with self-monitoring of blood glucose (controls; n = 53).
The World Health Organization (Five) Well-Being Index (WHO-5) and the EQ-5D-5L were used to assess nondiabetes-specific quality of life. The Diabetes Distress Scale, the Hypoglycemia Fear Survey and the Hypoglycemic Confidence Scale were used to assess diabetes-specific quality of life. Participants assigned to CGM also completed the CGM Satisfaction Survey to report on satisfaction with CGM.
Compared with the control group, the CGM group reported significantly greater increases in hypoglycemic confidence (P = .03). The greatest reported differences between the two groups were for staying safe from serious hypoglycemic problems while sleeping (P = .02) and driving (P = .05) and for participants’ rating of their partners’ overall hypoglycemic confidence (P = .05).
Regimen distress (P = .04) and interpersonal distress (P = .009) significantly differed between the two groups; however, there were no significant differences between the groups for hypoglycemic worry or for nondiabetes-specific quality-of-life measures.
Satisfaction with CGM was reported as high and perceived benefits were common whereas perceived hassles were rare. Decreases in total diabetes-related distress (P < .001) and hypoglycemic worry (P =.03) and increases in hypoglycemic confidence (P < .001) and overall well-being (P = .02) were moderately related to satisfaction with CGM after adjustment for participant demographic factors.
“We found that CGM contributes to statistically significant greater improvement in diabetes-specific [quality-of-life] measures (specifically, reductions in diabetes distress and increases in hypoglycemic confidence) in adults with [type 1 diabetes] taking [multiple daily insulin injections] compared with those who use [self-monitoring of blood glucose] only,” the researchers wrote. “Effect sizes for these group differences in diabetes-specific [quality of life] were in the low-moderate to moderate range, pointing to the practical significance of the findings. These results support the first of our two speculations about how CGM might positively influence [quality of life]: CGM can help adults with [type 1 diabetes] to regain or enhance their sense of personal control over their glucose control and, perhaps more broadly, their diabetes.” – by Amber Cox
Disclosure: Polonsky reports consultant fees from Abbott Diabetes Care and Dexcom. Please see the full study for a list of all other authors’ relevant financial disclosures.