Introduction: In people with well-managed type 1 diabetes (T1D), increased glycemic variability is related to poorer quality of life (QoL). However, less is known about hyperglycemia and QoL in the same population. Clinically, mild hyperglycemia (level 1) is defined as glucose >180 mg/dL and moderate (level 2) >250 mg/dL; however, this does not take into account diabetes management behaviors. This analysis aimed to assess the impact of high blood glucose (HBG) on QoL in well-managed individuals using survey and CGM data.
Methods: Adults with T1D (N = 71), 68.6% female, 93.2% white, aged 44.1 years, with diabetes for 26.7 years, completed an online survey through T1D Exchange Glu and uploaded CGM data via Tidepool.
Results: In this population, the average A1c was 6.5%, with 74% of participants ≤7.0%, suggesting that, overall, they are very well-managed. On average, this cohort reported that they consider HBG to be above 189 mg/dL, but 65% consider HBG to be a value below 180 mg/dL (range 100-175 mg/dl). Because the majority of participants considered HBG to be a value below the clinically recognized cut-off, this analysis explored events >140 mg/dL as a potentially meaningful cut point for HBG. Results indicated that that more events >140 mg/dL in the past 7 days were associated with poorer QoL. Participants with ≥24 events above 140 mg/dL in the past 7 days had an 83% increased risk for poor QoL as defined by the WHO-5.
Conclusions: Clinically relevant cutoffs of >180 mg/dL and >250 mg/dL are currently used to define mild (level 1) and moderate (level 2) hyperglycemia. This data suggests that in a very well-managed population, excursions >140 mg/dL have an impact on a persons’ well-being and healthcare providers need to consider how tightly managed an individual is when assessing psychosocial impacts of the disease. Limitations include small sample size and convenience sampling. Future research should further investigate the relationships of these factors in a larger sample.
C. Garey: None. A. Hughes: None. J. Bispham: None. J. Liu: None. L. Fuller: None. E.T. Nykaza: None. J.A. Meno: None. A. McAuliffe-Fogarty: None.