1585-P: Glycemic Regulation in Everyday Life with Type 1 Diabetes: How Does It Feel?

Introduction and Objective: Continuous Glucose Monitoring (CGM) metrics are increasingly emphasized in Type 1 Diabetes (T1D) care, yet little is known about how short-term glycemic regulation influences momentary physical and emotional experiences. This study paired ecological momentary assessment (EMA) with CGM to examine within-person effects of changes in glycemia on subsequent emotional and physical feeling states among adults with T1D. Methods: Participants (N = 182, 40±14.5 yrs, 54% women, 41% Latino, 29% White, 15% Black) wore blinded CGM and completed EMA ratings on smartphones (response scale: 1-100) of fatigue, negative and positive affect, stress, and pain 5-6xs/day for 14 days. Using dynamic structural equation modeling, we tested within-person lagged effects (with 95% confidence intervals) from 3 waking hours of CGM metrics (mean glucose, Time in Range TIR, 70-180 mg/dL, % time 181-250 mg/dL, % time 250 mg/dL, % time 70 mg/dL, and coefficient of variation CV) to feeling states measured at the end of that 3hr period and again 3hrs later. Results: Higher mean glucose (0.025; 0.001, 0.05) and lower TIR (-0.03; -0.055, -0.005) predicted more fatigue at the end of that 3hr period. Higher mean glucose (0.029; 0.005, 0.050) predicted more negative affect and more % time 70mg/dL (-0.36; -0.059, 0.006) predicted lower positive affect at the end of the period. For EMA ratings collected 3hrs later, higher mean glucose (0.023; 0.012, 0.032), lower TIR (-0.022; -0.036, -0.006) and greater % time 181-250 mg/dL (0.031; 0.008, 0.053) predicted more fatigue; higher CV also predicted more fatigue (0.076; 0.029, 0.120) but less stress (-0.033; -0.066, -0.004) and negative affect (-0.033; -0.056, -0.008). The remaining lags between CGM metrics and subsequent feeling states were nonsignificant. Conclusion: Short-term glycemic dysregulation was most consistently associated with subsequent fatigue within-persons, with fewer associations for affect and stress. Findings support the relevance of CGM metrics to the daily lived experience of adults with T1D. Disclosure J.S. Gonzalez: None. R. Hernandez: None. L. Nandoo: None. C. Hoogendoorn: None. S. Schneider: None. E. Pyatak: None. Funding National Institutes of Health (R01DK121298)