Canadian journal of diabetes · 2026
Continuous Glucose Monitoring Reduces Severe Diabetes Distress Independently of Glycemic Improvement in Adults With Type 1 Diabetes: A Prospective Study in a Public Health-Care Setting.
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Monteiro Nathalia Costa, Smith Lima Laís Prado, Almeida Freitas João Paulo, de Lourdes Passos Machado Maria, Gama Fernanda Gonçalves, Santos Silva Victória Dayane, Martins Leonardo Machado, de Santana Ferreira Lemos Sophia, Torres Gutemberg Lemos, Góes da Silva Danielle, Varela Mariana Garcez, Trevisan Talita Letícia, Vilela da Mota Silveira Mônica Sueli, Fernandes de Oliveira Santos Bruno, Oliveira de Santana Nathalie
Аннотация
OBJECTIVE: Although technology improves glycemic management, its psychological impact in resource-limited settings is less well explored. This study evaluated the impact of continuous glucose monitoring (CGM) on diabetes distress and glycemic outcomes in adults with type 1 diabetes (T1D) within a public health-care system.
METHODS: This prospective study enrolled 35 adults with T1D at a public centre in northeastern Brazil. Participants initiated CGM with monthly follow-ups. Diabetes distress was assessed at baseline and at 6 months using the Brazilian Type 1 Diabetes Distress Scale (T1DDS).
RESULTS: Participants had a mean T1D duration of 13±9.9 years and a baseline A1C of 9.13±1.87%. After 6 months, mean A1C decreased to 7.94±1.28% (mean difference = -1.19%; p=0.007). Time in range reached 54.4% within the first month and remained consistent throughout the follow-up. The total diabetes distress score decreased significantly from 2.86±0.88 at baseline to 2.32±0.85 at 6 months (mean difference = -0.28; p<0.001; Cohen's dz=0.76). The proportion of participants with severe distress dropped from 34.3% (n=12) to 14.3% (n=5) (p=0.002). Major improvements were observed in the management and family/social domains. Psychosocial benefits were observed regardless of the magnitude of A1C reduction (r=-0.182, p=0.384).
CONCLUSIONS: CGM implementation reduced diabetes distress, particularly in severe cases, and improved glycemic parameters in a resource-limited setting. The improvement in well-being independent of glycemic drop suggests that CGM is a valuable tool for both the clinical and psychosocial management of adults with T1D in public health systems.
METHODS: This prospective study enrolled 35 adults with T1D at a public centre in northeastern Brazil. Participants initiated CGM with monthly follow-ups. Diabetes distress was assessed at baseline and at 6 months using the Brazilian Type 1 Diabetes Distress Scale (T1DDS).
RESULTS: Participants had a mean T1D duration of 13±9.9 years and a baseline A1C of 9.13±1.87%. After 6 months, mean A1C decreased to 7.94±1.28% (mean difference = -1.19%; p=0.007). Time in range reached 54.4% within the first month and remained consistent throughout the follow-up. The total diabetes distress score decreased significantly from 2.86±0.88 at baseline to 2.32±0.85 at 6 months (mean difference = -0.28; p<0.001; Cohen's dz=0.76). The proportion of participants with severe distress dropped from 34.3% (n=12) to 14.3% (n=5) (p=0.002). Major improvements were observed in the management and family/social domains. Psychosocial benefits were observed regardless of the magnitude of A1C reduction (r=-0.182, p=0.384).
CONCLUSIONS: CGM implementation reduced diabetes distress, particularly in severe cases, and improved glycemic parameters in a resource-limited setting. The improvement in well-being independent of glycemic drop suggests that CGM is a valuable tool for both the clinical and psychosocial management of adults with T1D in public health systems.