Adults with diabetes who wore continuous glucose monitors reported a better quality of life on the day after their blood sugar moved around more than usual, as long as it stayed inside safe limits. The German study of 400 people will be presented at the European Association for the Study of Diabetes (EASD) annual meeting in Milan, September 28 to October 2.
If you have diabetes and use a glucose monitor, this is a fair reason to ask your doctor whether your targets are tighter than you need, especially if chasing a flat line is wearing you down. It is not a reason to let your readings drift above or below the safe range, or to change your insulin or other medicines on your own. That decision belongs with your doctor.
Key takeaways
- Days with higher-than-usual blood sugar swings, still within safe limits, were followed by better quality of life.
- More time in the normal range of 70 to 140 mg/dL was also linked to a better next day.
- The study shows a link, not cause, and it comes from a meeting presentation, not a full published paper.
What the study found
The PRO-MENTAL study, funded by the German Centre for Diabetes Research, was led by Professor Dominic Ehrmann of the Research Institute Diabetes Academy Mergentheim in Bad Mergentheim, Germany.
For 14 days in a row, participants rated their quality of life on the WHO-5 questionnaire, five statements such as “I have felt cheerful and in good spirits” and “I woke up feeling fresh and rested.” Their monitors tracked time below 70 mg/dL, time above 180 mg/dL, time between 70 and 140 mg/dL, and how much their glucose varied.
Of the 400 participants, 72% had type 1 diabetes, 28% had type 2, and 55% were women. Their reported age was 47 years (range 32 to 63), and their average HbA1c, a measure of long-term blood sugar control, was 7.6%.
After adjusting for age, sex, diabetes type, and the previous day’s quality of life, the EASD press release reports that:
- Higher glucose variability on one day was significantly linked to better quality of life the next day, and so was more time in the 70 to 140 range.
- Time above and below the safe range showed no statistically significant link.
- Better sleep the night before and more energy the day before also predicted a better next day.
- Blood sugar on a given day was not linked to how people rated that same day.
The authors suggest that people may feel worse when “attempting to minimise glucose fluctuations too strictly,” possibly because of the burden and limits that effort puts on daily life.
Dr. Kumar’s take
I am working from the EASD press release here; the full paper was not available to me.
This result fits a shift already under way in diabetes care. The large ACCORD trial found that pushing blood sugar very low in people with type 2 diabetes backfired, and the American Diabetes Association already allows looser targets for many older adults. Tighter is not always better, and this study adds the patient’s own sense of well-being to that argument.
It has limits. Nearly three in four participants had type 1 diabetes, and the reported age range ran from 32 to 63, so it says little about older adults with type 2 diabetes. It also shows only an association. An active, social day can push blood sugar around and also leave someone feeling good the next morning, and more energy the day before predicted a better next day here too. The swings may mark a fuller day rather than cause a better one.
Nor is it a license to run high. Time above 180 mg/dL did not come with better days, while time in the normal range did. The finding points to room to move inside safe limits, not permission to leave them. That matters now that glucose monitors are sold without a prescription and many people watch their graphs all day, chasing a perfectly flat line.
What it means for you
If keeping your graph flat is wearing you down, tell your doctor what the effort costs you, such as meals you skip or activities you avoid, and ask whether your targets could be relaxed.
Keep your readings inside the safe range, and make any change to insulin or other medicines with your doctor.
Sleep mattered here too. A better night’s sleep predicted a better next day, a pattern that also showed up when time-restricted eating improved sleep, mood, and quality of life in overweight adults.