525-P: Is It All In Your Head? Associations between Subjective and Objective Measures of Glycemic Variability

Abstract

CGM offers insights into daily glucose fluctuations. However, little is known how these insights impact feelings of diabetes distress in everyday life. We analyzed associations between subjective experiences of distress due to glucose fluctuations and CGM-derived parameters. In the DIA-LINK study, 203 people with type 1 diabetes completed ecological momentary assessment while using unblinded CGM over 17 days. Every evening, participants rated diabetes distress they experienced over a day using 5 adapted questions from the PAID questionnaire (feeling overwhelmed, alone, guilty, deprivation, diabetes takes up too much mental/physical energy). Also, they rated their daily distress specifically due to glucose fluctuations from 0 (not at all) to 10 (very much). Mean daily scores of these distress ratings were calculated per participants. Glucose parameters were calculated for the study period (mean glucose, coefficient of variation (CV) of glucose, % 180 mg/dl). Correlations were analyzed using Pearson’s r (Table 1). Ratings of distress were highly associated. CGM-derived glucose CV was neither associated with overall distress nor with specific distress due to glucose variability. This may indicate that glucose fluctuations can be a source of diabetes distress, but subjective experiences seem to be more important than objectively measured glucose fluctuations. Disclosure L. Priesterroth: None. D. Ehrmann: Speaker’s Bureau; Self; Berlin-Chemie AG. N. Hermanns: Advisory Panel; Self; Abbott, Research Support; Self; Berlin-Chemie AG, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH. A. J. Schmitt: None. B. Kulzer: Advisory Panel; Self; Berlin-Chemie AG, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH, Research Support; Self; Berlin-Chemie AG, Novo Nordisk, Speaker’s Bureau; Self; Berlin-Chemie AG, Dexcom, Inc., Novo Nordisk. Funding German Center for Diabetes Research (DZD) (82DZD01102)