The relationship between well‐being and HbA1c in adults with type 1 diabetes: A systematic review

Abstract

Background Diabetes has been associated with psychological problems, which in turn have been related to poorer glycemic control (glycosylated hemoglobin [HbA1c]). On the contrary, psychological well‐being constructs have been associated with superior medical outcomes, including better HbA1c. Aim The main objective of this study was to systematically review the existing literature about the relationships between subjective well‐being (SWB) and HbA1c in adults with type 1 diabetes (T1D). Methods Comprehensive searches were conducted in PubMed, Scopus, and Medline, time restricted to 2021, for studies examining the link between HbA1c and the cognitive (CWB) and affective (AWB) components of SWB. A total of 16 eligible studies were selected according to the inclusion criteria, of which 15 measured CWB and 1 AWB. Results Of the 15 studies included, 11 showed a relationship between CWB and HbA1c, with a higher level of HbA1c being related to poorer CWB. The other four studies did not find any significant association. Finally, the only study examining the relationship between AWB and HbA1c found a marginally association between these variables in the expected direction. Conclusion The overall data suggest that CWB is negatively related to HbA1c in this population, but these results are inconclusive. This systematic review offers clinical implications, such as the possible evaluation, prevention, and treatment of the problems associated with diabetes through the study and training of the psychosocial variables that may directly influence SWB. Limitations and future lines of investigation are discussed.

Sociodemographic and Clinical Determinants on Health-Related Quality of Life in Emerging Andalusian Adults with Type 1 Diabetes: A Cross-Sectional Study

“…Additionally, they reported an inversely proportional relationship between A1C levels and Well-Being. Similarly, the systematic review by Pérez-Fernández et al [ 13 ] suggests that higher A1C levels are associated to a reduced cognitive well-being.…”

“…Our findings also indicated that women had a higher score for the Interference with Life dimension than men. The trend of lower levels of HRQoL in T1DM and greater diabetes-related concern among women with respect to men has been widely discussed in the literature covering emerging adulthood and other age groups, regardless of the type of diabetes, blood glucose levels, or frequency of hyperglycemia episodes [ 6 , 13 , 15 , 17 , 22 ]. However, some studies have not found sex-based differences, yet highlight the importance of considering specific aspects related to sex in future research, such as the impact of menstruation [ 14 , 32 , 33 ].…”

“…Similarly, in the study by Carels et al [ 11 ], only 18% of emerging adults with T1DM showed an A1C level below 53 mmol/mol. This is compounded by the finding that HRQoL in T1DM is intricately linked to glycemic blood levels, with higher A1C values correlating with lower HRQoL [ 10 , 12 , 13 ]. The complexity of this relationship is accentuated in emerging adults when compared to those with type 2 diabetes [ 14 , 15 ].…”

“…The HRQoL in people with T1DM is influenced by a myriad of factors. These encompass disease duration [ 1 ], sex disparities with women often reporting lower HRQoL [ 6 , 13 , 15 , 17 ], and the post-high school transition to independence [ 18 ]. A diagnosis during emerging adulthood [ 19 ], especially in the latter stage (25–29 years), is associated with heightened anxiety and a subsequent decline in HRQoL in this demographic [ 20 ].…”

Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany

“…There is evidence that poor self-rated health is a predicting factor of developing depressive symptoms in individuals with diabetes [ 16 , 19 , 20 ]. Concerning psychological models, it must be considered that factors of glycemic control (HbA1c), long term complications, and diabetes duration affect the physical, social and mental well-being of people [ 38 , 39 ]. Future studies should include these factors regarding the link between diabetes, symptoms of depression/anxiety, HRQOL, and BMI.…”