Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study

Dzojic, Klara; Schönberger, Ema; Petrinović, Matea; Sladić Rimac, Daria; Erzic, Ema; Cigrovski Berkovic, Maja; Bakula, Miro; Bilić-Ćurčić, Ines; Canecki-Varžić, Silvija

doi:10.3390/medicina62050938

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Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study

by

Klara Dzojic

^1,2,

Ema Schönberger

^1,2,

Matea Petrinović

^1,2

,

Daria Sladić Rimac

^1,3

,

Ema Erzic

²,

Maja Cigrovski Berkovic

⁴

,

Miro Bakula

⁵,

Ines Bilić-Ćurčić

^1,2,*

and

Silvija Canecki-Varžić

^1,2

¹

Department of Endocrinology, Clinical Hospital Centre Osijek, 31000 Osijek, Croatia

²

Faculty of Medicine, Josip Juraj Strossmayer University in Osijek, 31000 Osijek, Croatia

³

Department of Nursing and Palliative Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University in Osijek, 31000 Osijek, Croatia

⁴

Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia

⁵

Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolic Diseases, Sveti Duh University Hospital, 10000 Zagreb, Croatia

^*

Author to whom correspondence should be addressed.

Medicina 2026, 62(5), 938; https://doi.org/10.3390/medicina62050938 (registering DOI)

Submission received: 3 April 2026 / Revised: 6 May 2026 / Accepted: 9 May 2026 / Published: 11 May 2026

(This article belongs to the Special Issue Diabetes and Cardiovascular Disease: Addressing Mechanisms and Therapeutic Strategies Across the Cardiometabolic Continuum)

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Abstract

Background and Objectives: Continuous glucose monitoring (CGM) improves glycemic control in type 2 diabetes (T2DM), but its effects on diabetes-related distress and quality of life (QoL), particularly in patients on intensive insulin therapy, are less well studied. Aim: We aim to assess the impact of CGM on glycemic control, diabetes distress, and QoL in adults with T2DM on intensified insulin therapy. Materials and Methods: This prospective observational study included 226 adults with T2DM using multiple daily insulin injections or basal–bolus therapy. CGM was initiated at baseline. HbA1c, fasting glucose, and lipid profile were measured at baseline, 3, 6, 9, and 12 months. Diabetes-related distress (DDS-17) and quality of life (MDQoL-17) were assessed at the same time points. Longitudinal changes were analyzed using linear mixed-effects models. Results: Mean age was 66 ± 9.1 years; 55% were male. HbA1c decreased from 8.56 ± 1.87% to 7.20 ± 0.90% at 3 months (p < 0.001) and remained improved at 12 months (7.21 ± 1.04%). Diabetes distress declined significantly over time (β = −0.025/month; p = 0.001). Older age and lower income were associated with higher distress. Quality of life improved significantly during follow-up; higher income predicted better QoL, while greater distress predicted poorer QoL. HbA1c did not independently influence QoL. CGM metrics (GMI, mean glucose, TIR, glycemic variability) remained stable after initial improvement. Conclusions: In 226 insulin-treated T2DM patients, implementation of CGM as part of a structured insulin intensification strategy was associated with sustained improvements in glycaemic control, reduced diabetes-related distress, and enhanced quality of life over 12 months. These findings support routine CGM use and highlight the importance of addressing psychosocial outcomes in diabetes care.

Keywords: type 2 diabetes; CGM; insulin therapy; HbA1c; distress; quality of life

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MDPI and ACS Style

Dzojic, K.; Schönberger, E.; Petrinović, M.; Sladić Rimac, D.; Erzic, E.; Cigrovski Berkovic, M.; Bakula, M.; Bilić-Ćurčić, I.; Canecki-Varžić, S. Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study. Medicina 2026, 62, 938. https://doi.org/10.3390/medicina62050938

AMA Style

Dzojic K, Schönberger E, Petrinović M, Sladić Rimac D, Erzic E, Cigrovski Berkovic M, Bakula M, Bilić-Ćurčić I, Canecki-Varžić S. Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study. Medicina. 2026; 62(5):938. https://doi.org/10.3390/medicina62050938

Chicago/Turabian Style

Dzojic, Klara, Ema Schönberger, Matea Petrinović, Daria Sladić Rimac, Ema Erzic, Maja Cigrovski Berkovic, Miro Bakula, Ines Bilić-Ćurčić, and Silvija Canecki-Varžić. 2026. "Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study" Medicina 62, no. 5: 938. https://doi.org/10.3390/medicina62050938

APA Style

Dzojic, K., Schönberger, E., Petrinović, M., Sladić Rimac, D., Erzic, E., Cigrovski Berkovic, M., Bakula, M., Bilić-Ćurčić, I., & Canecki-Varžić, S. (2026). Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study. Medicina, 62(5), 938. https://doi.org/10.3390/medicina62050938

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Association of Continuous Glucose Monitoring with Glycaemic, Distress, and Quality of Life Outcomes in Insulin-Treated Type 2 Diabetes: A 12-Month Prospective Study

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