Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Glycaemic Variability is Associated with Adverse Psychological Well-being in Adults with Type 1 Diabetes  (#193)

Daniel Fineberg 1 , C Hendrieckx 2 3 , Beverley Balkau 4 , Jane Speight 2 3 , Neale Cohen 1
  1. Baker IDI, Melbourne , VIC, Australia
  2. Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, Burwood, VIC, Australia
  3. Australian Centre for Behavioural Research in Diabetes, Melbourne, Vic, Australia
  4. CESP Center for Research in Epidemiology and Population Health, Paris, France

Aim

To explore the relationship between blood glucose (BG) meter readings and emotional well-being in adults with type 1 diabetes.

Methods

Adults with type 1 diabetes attending Baker IDI specialist diabetes clinic completed questionnaires: general emotional well-being (WHO-5), diabetes-specific positive well-being (DPWB; 4-item subscale of W-BQ28), diabetes-related distress (PAID), and fear of hypoglycaemia (HFS). BG meters were downloaded and glucose data from the previous 4 weeks was analysed.  Readings were defined as above target >8.0mmol/L, within target 3.5-8.0mmol/L and below target <3.5mmol/L; glucose SD was used to describe variability.

Results

104 participants (45% female) had BG meters downloaded: mean(SD) age 46(16) years, diabetes duration 22(13) years, HbA1c 7.6(0.9)%, and BG variability 4.4(1.1)mmol/L. BG readings were above target (57%), within target (36%) and below target (7%). Adjusting for age, gender and diabetes duration, glucose variability was associated with reduced emotional well-being, both general (WHO-5: r=‑0.31, p=0.002) and diabetes specific (W-BQ28: r=-0.30, p=0.002).

Following multivariate analysis, higher HbA1c correlated with less reported hypoglycaemia (r=-0.36, p=0.0001) but lower diabetes-specific positive well-being (W-BQ28: r=-0.28, p=0.002). Greater glycaemic variability was negatively correlated with emotional well-being, both general (WHO-5: r=-0.28, p=0.003) and diabetes-specific (W-BQ28: r=-0.26, p=0.006). Number of BG readings <3.5mmol/L was not  associated with decreased wellbeing, and total number of BG checks was associated with greater diabetes-specific positive well-being (W-BQ28: r=0.22, p=0.02).

Conclusions

Glycaemic variability and hyperglycaemia impact negatively on general emotional well-being and diabetes-specific positive well-being, but not on diabetes-related distress. More frequent monitoring is associated with greater diabetes-specific positive well-being.