The impact of continuous glucose monitoring on markers of quality of life in adults with type 1 diabetes: further findings from the DIAMOND randomized clinical trial
Abstract
OBJECTIVE Continuous glucose monitoring (CGM) improves glycemic control, but data are inconclusive about its influence on quality of life (QOL). We investigated the impact of 24 weeks of CGM use on QOL in adults with type 1 diabetes (T1D) who use multiple daily insulin injections. RESEARCH DESIGN AND METHODS DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes) was a prospective randomized trial that assessed CGM versus self-monitoring of blood glucose (SMBG) only in 158 adults with poorly controlled T1D. At baseline and study end, participants completed QOL measures that assessed overall well-being (WHO-5), health status (EQ-5D-5L), diabetes distress (DDS), hypoglycemic fear (worry subscale of the HFS-II), and hypoglycemic confidence (HCS). At study end, CGM participants completed the CGM Satisfaction Survey. Linear regression analyses compared treatment group changes in QOL outcomes over time. Associations between CGM satisfaction and change in QOL outcomes and in glycemic control indices were assessed. RESULTS The CGM group demonstrated a greater increase in hypoglycemic confidence (P = 0.01) and a greater decrease in diabetes distress (P = 0.01) than the SMBG group. No significant group differences in well-being, health status, or hypoglycemic fear were observed. CGM satisfaction was not significantly associated with glycemic changes but was associated with reductions in diabetes distress (P < 0.001) and hypoglycemic fear (P = 0.02) and increases in hypoglycemic confidence (P < 0.001) and well-being (P = 0.01). CONCLUSIONS CGM contributes to significant improvement in diabetes-specific QOL (i.e., diabetes distress, hypoglycemic confidence) in adults with T1D, but not with QOL measures not specific to diabetes (i.e., well-being, health status). CGM satisfaction was associated with most of the QOL outcomes but not with glycemic outcomes.
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Numerous studies have demonstrated significant clinical benefits of CGM use in people with diabetes regardless of insulin delivery method.
“Numerous studies have demonstrated significant clinical benefits of CGM use in people with diabetes regardless of insulin delivery method (1-15).”
From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [5]
Integration of continuous glucose monitoring (CGM) into the treatment plan soon after diagnosis improves glycemic outcomes, decreases hypoglycemic events, and improves quality of life for individuals with type 1 diabetes.
“Integration of continuous glucose monitoring (CGM) into the treatment plan soon after diagnosis improves glycemic outcomes, decreases hypoglycemic events, and improves quality of life for individuals with type 1 diabetes (18-23).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [23]
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- Authors
- Polonsky, W. H., Hessler, D., Ruedy, K. J., & Beck, R. W.
- Affiliations
- University of California San Diego (US)
- University of California, San Francisco (US)
- Jaeb Center for Health Research (US)
- Corresponding author
- Polonsky, William H.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2017-04-07
- Volume
- 40
- Issue
- 6
- Pages
- 736-741
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2604156892
- Cited by
- 346
- References
- 22
- Citations by year
- 2026: 41 · 2025: 35 · 2024: 50 · 2023: 45 · 2022: 39 · 2021: 33 · 2020: 33 · 2019: 35 · 2018: 30 · 2017: 5
- FWCI
- 22.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- continuous glucose monitoring, type 1 diabetes, quality of life, diabetes distress, self-monitoring of blood glucose, multiple daily insulin injections, glycemic control, adults with diabetes
- MeSH terms
- Adult, Aged, Anxiety, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prospective Studies, Quality of Life, Blood Glucose Self-Monitoring, Biomarkers, Linear Models
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