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