The interplay between psychological well-being, diabetes-related distress, and glycemic control: A continuous glucose monitoring analysis from a population of adolescents with type 1 diabetes

Aims: This study aims to explore the relationships between glucose control, psychological well-being, and diabetes-related distress in a population of adolescents with T1D. Methods: We conducted a cross-sectional study on adolescents with T1D attending a Pediatric Diabetes Unit. Demographic, clinical, and glycemic data were collected, including continuous glucose monitoring (CGM) metrics. Psychological well-being was assessed using the PERMA-Profiler, while diabetes-related distress was measured using the Problem Areas in Diabetes-Teen Version (PAID-T) questionnaire. Results: Among 133 enrolled adolescents, those with HbA1c ≤ 7 % exhibited significantly higher well-being scores (p = 0.007) and lower distress scores (p = 0.035). Higher time in range was positively associated with well-being (p = 0.002), while glycemic variability negatively impacted psychological outcomes (p = 0.023). Female sex (p = 0.021), longer disease duration (p = 0.022), and the absence of insulin pump therapy (p = 0.032) were significantly associated to higher diabetes-related distress. Conclusions: Glycemic control is closely related to psychological well-being of adolescents living with T1D. The adoption of diabetes technologies may play a crucial role in reducing diabetes-related distress. Future longitudinal studies should investigate the impact of psychological interventions on CGM outcomes and overall quality of life in adolescents with T1D.