783-P: Can Mood and Energy Levels Be Predicted by Preceding Glucose Values? Combining Ecological Momentary Assessment (EMA) and Continuous Glucose Monitoring (CGM)

Abstract

For association with glycemic control, psychosocial research almost exclusively used retrospective questionnaire data to assess psychosocial outcomes. Little is known about the immediate, real-time effects of glucose values on psychosocial outcomes. In an observational study, 152 people with type 1 diabetes were equipped with CGM and completed a Smartphone-based EMA-survey 4-times a day over 18 days. Participants rated their mood and energy level separately on a single-item scale from 0 (very poor) to 10 (very good). Glucose data 90 minutes prior to each rating was extracted and mean glucose, time in range, time in hypoglycemic ranges (<70, <55 mg/dl), time in hyperglycemic ranges (>180, >250 mg/dl), and the mean absolute difference (MAD) of consecutive glucose values were calculated. Multilevel regression analyses were conducted with mood and energy levels as dependent variables and each parameter of glycemic control (90min prior) as independent variable, controlled for the overall level of glycemic control. Better mood was significantly predicted by lower mean glucose levels (p=.003), higher time in range (p=.003), and less hyperglycemic values (>180 mg/dl: p=.021; >250 mg/dl: p=.002). No significant associations were found for hypoglycemic values and MAD. Higher energy levels were significantly predicted by lower mean glucose levels (p=.012), higher time in range (p=.001), less hypoglycemic values (<70 mg/dl: p<.001; <54 mg/dl: p=.023), less values in the severe hyperglycemic range (>250 mg/dl: p<.001). Lower MAD predicted higher energy levels (p=.047). Ratings of mood and energy were significantly affected by immediately preceding glucose levels. While hyperglycemic values were more important for mood, hypoglycemic values were more important for energy. These preliminary findings have important implications for our understanding of real-time effects of hypo- and hyperglycemic glucose levels. Disclosure D. Ehrmann: Speaker’s Bureau; Self; Abbott, Berlin-Chemie AG, Glooko, Inc. Other Relationship; Self; Dexcom, Inc., Roche Diabetes Care. A.J. Schmitt: None. P. Rubertus: None. B. Kulzer: Research Support; Self; Abbott, AstraZeneca, Berlin-Chemie AG, Roche Diabetes Care. Speaker’s Bureau; Self; Abbott, Ascensia Diabetes Care, Berlin-Chemie AG, Eli Lilly and Company, Medtronic, Novo Nordisk Inc., Roche Diabetes Care. N. Hermanns: Advisory Panel; Self; Roche Diabetes Care. Research Support; Self; Abbott, AstraZeneca, Berlin-Chemie AG. Funding German Center for Diabetes Research (FKZ82DZD1102A)