Can CGM Improve Your Mood and Quality of Life?

By Gabby Mitchell

Research shows that changes in Time in Range (TIR) affect your mood and that continuous glucose monitoring may help people with diabetes achieve better emotional health.  

Did you know that more stable blood sugar levels have been associated with better moods for people with diabetes? Navigating the daily demands of diabetes can greatly affect a person’s mental health, and careful management of glucose levels may help someone experience more positive mindsets. Researchers have started to see a relationship between emotional health and time spent in a regular glucose range. Emerging evidence shows that your Time in Range (TIR) could be an important factor in your mental and emotional wellbeing. This relationship could go in either direction: increased TIR may help improve your mental health and quality of life, or, mental and emotional wellbeing may allow you to better manage your diabetes and achieve higher TIR. 

While hypoglycemia (low blood sugar) has been shown to lead to negative moods and affect a person’s cognitive function, relatively little research has been done to examine the mood effects of hyperglycemia (high blood sugar), glycemic variability (blood sugar swings), and Time in Range (TIR). Each of these elements of diabetes management can be measured by continuous glucose monitoring (CGM). 

How are glucose levels related to mood and quality of life?

Recent research has investigated the relationship between TIR and the daily moods of people with diabetes. In a study of 219 adults with type 1 diabetes who completed nightly reports of positive and negative moods over a 14-day period, individuals felt more cheerful, full of energy, calm, and relaxed during times when they experienced a higher TIR throughout the day. 

Those who spent more time in severe hyperglycemia (glucose levels over 300 mg/dl) reported more negative mood states, including frustration and irritability. Parents of children with type 1 diabetes using CGM reported that when their children experienced hyperglycemia, they also displayed negative attitudes, such as irritability and difficulty concentrating. Following a blind CGM test (where participants were kept unaware of their sensor glucose levels), adults with diabetes also showed a relationship between higher glucose levels and negative moods.  

Other studies have shown that higher TIR and CGM use leads to improvements in a person’s quality of life:

• In a recent study, participants with type 1 and type 2 diabetes demonstrated improvements in psychological and social health outcomes after three months of using continuously-scanned CGM. These included a decrease in emotional, regimen-related, and interpersonal distress.

• Participants with type 1 and type 2 diabetes in another study stated that the time spent in their ideal glucose range had a “big impact” on their daily life in both diabetes management and overall mindset. The majority of participants with type 1 diabetes ranked TIR as the greatest contributor to a positive mindset. 

• Adults with type 1 diabetes describe positive experiences using intermittently-scanned CGM, calling it “life-changing and convenient,” and showed significant reductions in diabetes distress.

Why is this important?

People with diabetes often experience high amounts of diabetes distress, which is caused by things like remembering to take medications correctly or coping with fears of low glucose levels. In a study of 506 adults with type 2 diabetes who were assessed (participants answered a questionnaire and had a laboratory visit) at nine-month intervals over an 18-month period, compared to people without diabetes, those with diabetes were shown to have higher rates of various mental health conditions, including: 

• A 60% higher rate of major depressive disorder (MDD). MDD is characterized by a consistently depressed mood, long term loss of pleasure or interest in life, and other symptoms such as poor sleep and feelings of inadequacy.

• A 123% higher rate of general anxiety disorder (GAD). GAD is characterized by excessive anxiety in two or more aspects of life such as work, social relationships, finances, etc., and can be accompanied by symptoms such as hyperventilation and palpitations.

• An 85% higher rate of having a panic disorder. Panic disorder is a type of anxiety disorder causing panic attacks and feeling like you are losing control.

The introduction of CGM has decreased emotional distress and hypoglycemic anxiety for people with diabetes, and increased TIR is associated with positive moods and relaxation. Work with your healthcare team to develop TIR goals that support your emotional health – you can read our advice here. To learn about using CGM data to increase your TIR, click here. 

This article is part of a series on Time in Range.

The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand time in range to maximize patient’s health. Learn more about the Time in Range Coalition here.