Glycemic Control in Patients With Type 1 Diabetes Worse Around Holidays, Winter Months


A new study from Dartmouth College found that patients maintained healthier blood sugar levels from April to September.

Patients with type 1 diabetes who already handle their condition poorly have worse glycemic control during the holiday season and winter months, according to new research published in Science Advances.1

Diabetes affects roughly 10.5% of the world’s population and its prevalence is expected to rise in the coming decades. Although prior research has shown seasonal variations in lifestyle habits can contribute to weight gain and impact diabetes outcomes, there is currently a lack of data on similar glycemic trends.

Investigators from Dartmouth College conducted a study to investigate temporal changes in glycemic trends by analyzing continuous glucose monitor (CGM) data.

“There are a lot of questions around how to personalize [diabetes] management," Temiloluwa Prioleau, a co-author on the study, said in a release.2 "[L]earning from each individual's unique data can set the course towards delivering the best possible outcome for them."

The study included 137 patients aged 2 to 76 who primarily had type 1 diabetes over the course of 9 months to 4.5 years. Two cohorts were involved: 1 cohort had 100 patients who use sensor-augmented insulin pump therapy, while the other cohort had 37 patients who use varying forms of insulin therapy for daily management.

In total, the study included over 90000 days of CGM data. Participants were required to a have minimum of 9 months of CGM data with at least 70% of readings present during the collection period.

Investigators found that glycemic control decreased significantly around the holiday season for participants of all ages, with the largest declines seen on New Year’s Day and Christmas. Despite being a warm weather holiday—when glucose control tends to be better—the Fourth of July was number 3 on the list.

Additionally, patients were seen to maintain healthier glucose levels from April to September, when activity levels tend to be higher. Blood sugar levels tended to be below average between October and February.

Study limitations include not analyzing trends such as food, insulin use, and physical activity, not including data on differences across genders, and unequal representation of subjects across age groups.

"Our goal is to highlight what we're observing at a population level,” said Prioleau. “Hopefully, this will encourage people to leverage their own past data to inform and shape their future care, through behavioral changes when feasible, or through other types of intervention."

1. Prajakta B, Bartolome A, Stanger C, et al. Understanding temporal changes and seasonal variations in glycemic trends using wearable data. Sci Adv. (2023).DOI:10.1126/sciadv.adg2132
2. Wearable devices show who may need more help managing diabetes. News Release. Dartmouth. September 25, 2023. Accessed September 28, 2023.
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