Quality of Life in Women With Gestational Diabetes Mellitus and Treatment Satisfaction Upon Intermittently Scanned Continuous Glucose Monitoring

Abstract

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM).

Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy.

Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, -6.98 ± 2.49, P < 0.001) and the least impact on the sex life (-0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy.

Conclusion: Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control. Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Keywords: Continuous Glucose Monitoring; Diabetes, Gestational; Quality of life; Satisfaction.

Fig. 1. Results of the ADDQoL: General quality of life during pregnancy and GDM–dependent quality of life (A) and 19 domain–specific items (B). (A) The general quality of life during pregnancy was assessed using the question “In general, my present quality of life is:”, and GDM–dependent quality of life was evaluated by “If I did not have diabetes, my QoL would be:”. (B) Weighted impact score is calculated by multiplying the impact score and the importance score, ranging from –9 to +3. A lower score indicates a worse quality of life. The range for the impact score is from –3 (maximum negative impact) to +1 (positive impact). The range for the importance score is from +3 (very important) to 0 (not at all important).

QoL = quality of life, ADDQoL = Audit of Diabetes-Dependent Quality of Life Questionnaire, SD = standard deviation, GDM = gestational diabetes mellitus.