Play store
Keeping blood sugar levels extremely steady may have an unexpected downside for some people with diabetes, with new research suggesting that greater glucose fluctuations within safe limits may sometimes be linked to better quality of life.
The findings, to be presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan from September 28 to October 2, indicate that people with type 1 or type 2 diabetes sometimes reported better well-being after days when their glucose levels varied more.
Researchers led by Professor Dominic Ehrmann of FIDAM (Research Institute Diabetes Academy Mergentheim) in Bad Mergentheim, Germany, combined data from continuous glucose monitoring (CGM) devices with daily assessments of participants’ well-being.
The study was based on the PRO-MENTAL project, funded by the German Center for Diabetes Research. Participants reported their quality of life every day for 14 consecutive days using ecological momentary assessment based on the WHO-5 Well-Being Index.
The questionnaire assessed whether participants felt cheerful and in good spirits, calm and relaxed, active and energetic, refreshed after sleep and interested in their daily activities. Researchers also collected daily information on sleep, stress, mood and energy.
The team analysed CGM data from the same period, including time spent below 70 milligrams per decilitre, above 180 mg/dL, within the normal range of 70-140 mg/dL and measures of glucose variability.
The analysis included 400 people with diabetes, 72 per cent of whom had type 1 diabetes and 28 per cent type 2 diabetes. The participants had a mean age of 47 and an average HbA1c level of 7.6 per cent.
Two findings stood out. Spending more time within the normal glucose range on one day was significantly associated with a better quality of life the following day. At the same time, greater glucose variability on the previous day was also associated with higher next-day quality of life.
The researchers found no significant link between the amount of time spent above or below the safe glucose range on one day and quality of life the following day.
Better sleep and higher energy levels on the previous day were also associated with improved well-being the next day.
Interestingly, glucose measurements taken on the same day were not significantly associated with quality of life on that day.
The researchers stressed that the findings do not mean poor glucose control is beneficial. Rather, they said the association between glucose variability and well-being could point to the potential burden of trying to eliminate every normal fluctuation in blood sugar.
For some people, efforts to keep glucose levels extremely stable may involve additional restrictions on food, exercise or daily activities, potentially making everyday life more difficult or less enjoyable.
The researchers said the findings highlight the importance of considering quality of life alongside glucose measures when assessing diabetes management.