Greater glycemic variability linked to improved next-day quality of life in diabetes

Healio reports on findings from the PRO-MENTAL study, which will be presented at the European Association for the Study of Diabetes annual meeting in Milan. The study followed 400 people with type 1 or type 2 diabetes for 14 days, combining self-reported quality-of-life measures with continuous glucose monitoring data. Participants reported daily quality of life, sleep quality, perceived stress, mood and energy, while researchers analyzed glucose metrics including time in range and glycemic variability.

The findings were somewhat counterintuitive. Higher time in the normal glucose range, defined as 70 mg/dL to 140 mg/dL, was associated with better next-day quality of life, as expected. But greater glucose variability was also linked with higher next-day quality of life, provided the fluctuations occurred within safer ranges. Time below 70 mg/dL and time above 180 mg/dL were not associated with next-day quality-of-life scores. Better sleep quality and higher energy levels were also linked with improved quality of life the following day.

Dominic Ehrmann, PhD, of the Research Institute of the Diabetes-Academy Mergentheim in Germany, said the study suggests that overly strict efforts to avoid any glucose fluctuation may negatively affect some people’s lives. He argued that glucose changes within normal ranges should be understood as part of daily life, especially as CGM and automated insulin delivery systems make glucose data constantly visible. The broader implication is not that glucose targets are unimportant, but that diabetes care should weigh person-reported outcomes alongside numeric metrics, especially when intensive monitoring increases distress or restricts normal activity and eating.