Glycemic Variability and Its Impact on Quality of Life in Adults With Type 1 Diabetes.
BACKGROUND
There is evidence suggesting that glycemic variability reduces quality of life (QoL) in people with type 2 diabetes, but this association has not been explored in type 1 diabetes. We aimed to assess whether glycemic variability has an impact on QoL in adults with established type 1 diabetes using multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII).


METHODS
Participants wore a blinded continuous glucose monitor for up to 5 days and completed the diabetes quality of life (DQOL) questionnaire. Glycemic variability measures were calculated using the EasyGV version 9.0 software. A correlation analysis was performed to assess whether there was a relationship between glycemic variability and measures of QoL.


RESULTS
In all, 57 participants with type 1 diabetes (51% male, 65% on CSII, 35% on MDI, mean [SD] age 41 [13] years, duration of diabetes 21 [12] years, HbA1c 63 [12] mmol/mol [7.9% (1.1)], body mass index 25.2 [4.0] kg/m(2)) were included in the analysis. No significant associations between glycemic variability and DQOL total or subscale scores were demonstrated. The glycemic variability was significantly higher for MDI participants compared to CSII participants (P < .05 for all glycemic variability measures), but no significant difference in QoL between the 2 treatment modality groups was observed.


CONCLUSIONS
Treatment with CSII is associated with lower glycemic variability compared to MDI. Despite this, and contrary to findings in type 2 diabetes, this study did not find an association between glycemic variability and QoL in adults with relatively well-controlled type 1 diabetes, irrespective of whether they are on MDI or CSII.
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK m.reddy@imperial.ac.uk.
Monika
M
Reddy
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
Ian F
IF
Godsland
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Katharine D
KD
Barnard
Centre for Bio-Inspired Technology, Department of Electrical and Electronic Engineering, Institute of Biomedical Engineering, Imperial College London, London, UK.
Pau
P
Herrero
Centre for Bio-Inspired Technology, Department of Electrical and Electronic Engineering, Institute of Biomedical Engineering, Imperial College London, London, UK.
Pantelis
P
Georgiou
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
Hazel
H
Thomson
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
Desmond G
DG
Johnston
Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
Nick S
NS
Oliver
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
continuous glucose monitoring; glycemic variability; quality of life; type 1 diabetes