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.

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.