Glycemic Variability and Quality of Life Among Adults Receiving Long-Term Diabetes Therapy
DOI:
https://doi.org/10.61336/jdme.0602.02Keywords:
Glycemic variability, quality of life, diabetes, continuous glucose monitoring, diabetes distressAbstract
Glycemic variability may influence daily functioning and well-being in adults receiving long-term treatment for diabetes. This study evaluated the association between glycemic variability and health-related quality of life among adults with established diabetes receiving stable long-term therapy. A cross-sectional study was conducted among 148 adults receiving diabetes treatment for at least three years. Glycemic variability was assessed using continuous glucose monitoring over 14 days, while quality of life was evaluated using a validated diabetes-specific questionnaire. Participants with higher glucose variability reported lower overall quality-of-life scores, greater diabetes-related distress, and more frequent treatment-related concerns. Glycemic coefficient of variation demonstrated an inverse association with quality-of-life scores after adjustment for age, sex, diabetes duration, HbA1c, treatment type, and presence of complications. The association was particularly evident for emotional well-being and treatment burden. These findings suggest that glycemic variability may be associated with quality of life independently of average glycemic control.
References
1. American Diabetes Association Professional Practice Committee. Glycemic goals and hypoglycemia: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
2. Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, et al. Clinical targets for continuous glucose monitoring data interpretation. Diabetes Care. 2019;42(8):1593–1603.
3. Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40(12):1631–1640.
4. Beck RW, Connor CG, Mullen DM, Wesley DM, Bergenstal RM. The fallacy of average: how using HbA1c alone to assess glycemic control can be misleading. Diabetes Care. 2017;40(8):994–999.
5. Kovatchev BP. Metrics for glycaemic control—from HbA1c to continuous glucose monitoring. Nat Rev Endocrinol. 2017;13(7):425–436.
6. Monnier L, Colette C, Owens DR. Glycemic variability: the third component of the dysglycemia in diabetes. Endocrinol Metab Clin North Am. 2019;48(4):661–679.
7. Rodbard D. Glucose variability: a review of clinical applications and research developments. Diabetes Technol Ther. 2018;20(S2):S25–S36.
8. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15(3):205–218.
9. Fisher L, Hessler D, Polonsky WH, Mullan J. When is diabetes distress clinically meaningful? Diabetes Care. 2012;35(2):259–264.
10. Peyrot M, Rubin RR. Behavioral and psychosocial interventions in diabetes. Diabetes Care. 2007;30(10):2433–2439.
11. DeFronzo RA, Ferrannini E, Groop L, Henry RR, Herman WH, Holst JJ, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers. 2015;1:15019.
12. Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, et al. The management of type 1 diabetes in adults. Nat Rev Dis Primers. 2021;7:1.
13. American Diabetes Association Professional Practice Committee. Diabetes technology: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
14. Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, et al. Assessment of diabetes-related emotional distress. Diabetes Care. 1995;18(6):754–760.
