title: The Impact of Continuous Glucose Monitoring on Markers of Quality of Life in Adults With Type 1 Diabetes: Further Findings From the DIAMOND Randomized Clinical Trial.
abstract: Continuous glucose monitoring (CGM) improves glycemic control, but data are inconclusive about its influence on quality of life (QOL). We investigated the impact of 24 weeks of CGM use on QOL in adults with type 1 diabetes (T1D) who use multiple daily insulin injections.
  
  
  
  DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes) was a prospective randomized trial that assessed CGM versus self-monitoring of blood glucose (SMBG) only in 158 adults with poorly controlled T1D. At baseline and study end, participants completed QOL measures that assessed overall well-being (WHO-5), health status (EQ-5D-5L), diabetes distress (DDS), hypoglycemic fear (worry subscale of the HFS-II), and hypoglycemic confidence (HCS). At study end, CGM participants completed the CGM Satisfaction Survey. Linear regression analyses compared treatment group changes in QOL outcomes over time. Associations between CGM satisfaction and change in QOL outcomes and in glycemic control indices were assessed.
  
  
  
  The CGM group demonstrated a greater increase in hypoglycemic confidence (P= 0.01) and a greater decrease in diabetes distress (P= 0.01) than the SMBG group. No significant group differences in well-being, health status, or hypoglycemic fear were observed. CGM satisfaction was not significantly associated with glycemic changes but was associated with reductions in diabetes distress (P< 0.001) and hypoglycemic fear (P= 0.02) and increases in hypoglycemic confidence (P< 0.001) and well-being (P= 0.01).
  
  
  
  CGM contributes to significant improvement in diabetes-specific QOL (i.e., diabetes distress, hypoglycemic confidence) in adults with T1D, but not with QOL measures not specific to diabetes (i.e., well-being, health status). CGM satisfaction was associated with most of the QOL outcomes but not with glycemic outcomes.
authors.affiliation: University of California, San Diego, San Diego, CA whp@behavioraldiabetes.org.|Behavioral Diabetes Institute, San Diego, CA.
authors.forename: William H
authors.identifier: 0000-0001-9064-6144
authors.initials: WH
authors.lastname: Polonsky
authors.affiliation: University of California, San Francisco, San Francisco, CA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Hessler
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
authors.affiliation: Jaeb Center for Health Research, Tampa, FL.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000097:blood; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin