Measurement

Good diabetes management is driven by good data. Blood glucose values, carbohydrate counts and so much more are all essential in day to day diabetes management. This data can be especially helpful in giving people with diabetes (PWD) insight about how their diabetes management is going and and how it changes over time. Without good data diabetes management would be a lot more difficult – and a lot more dangerous.

Have you have thought about how, even though diabetes management is driven by data, some of the most difficult parts of living with diabetes aren’t that easy to measure? Unfortunately, measuring the emotional aspects of diabetes is not as simple as testing a drop of blood or calculating how many grams of carbohydrates are in a sandwich. We do have some good measures of diabetes distress, but the reality is they are not quick and easy to take, and the results are not always that accurate or useful in helping PWD better manage their diabetes.

So you may be asking yourself if finding an easy way to measure diabetes-related emotional well being (DREWB) is really that important.  I would argue that it is. I understand that knowing DREWB is certainly not as essential to day-to-day diabetes management as blood glucose monitoring, but being able to measure how one is dealing with the emotional aspects of diabetes could be really helpful for PWD and their health care teams. Here are some reasons why.

A lot of people believe they have more control over things that they can measure – and this is oftentimes true. If you can measure something, then you can set specific goals about where you want the result to be and you can find things you can do to have an impact on the outcome. Feeling in control can help making difficult changes a bit easier. But because we can’t measure DREWB like we can measure blood glucose, it can feel like you have a lot less control over it. This is not to say that even if we could measure DREWB that PWD would feel in control of it, but I bet that many PWD would feel more in control of their emotional well-being. Having access to regular data would give PWD the ability to see small, incremental changes in how they are doing over time. Seeing these trends can help PWD to make a more deliberate choice, either continue what they are doing (and celebrate their successes) or take steps to manage any challenges they identify before they get worse.

If PWD measured their DREWB on a regular basis, it would give them the opportunity to see how their emotional well-being impacts their diabetes management. How helpful would it be if we could compare blood glucose values and emotional well-being values, in a numerical way, over the course of time. If we could measure DREWB, it could help PWD better understand how their emotions effect their diabetes-management behavior and could give them the information they need to help them overcome the barriers they identify. Giving PWD the ability to represent this relationship numerically could be very helpful.

Finally, if we had a quick and easy way to measure DREWB, it might help make the emotional struggles of living with diabetes a bit less isolating. A lot of PWD feel like they are the only one who is experiencing what they are going through. Measuring DREWB would let PWD see how what they are experiencing compares to other PWD. It may also give folks a better idea about when getting some additional support in dealing with their difficult emotions would be helpful.

This all sounds great, right? Why don’t we develop a quick, easy, patient-friendly way to measure DREWB? Measuring emotions is messy, and definitely a lot more difficult than measuring something like blood glucose. Glucose is an objective value. A particular concentration of glucose in the blood will yield (almost) the same value every time. Measuring emotions is a lot messier, and less accurate. The best way we have right now to measure emotions is self-report, and people are not typically very good at accurately reporting their emotional experience. Self-reporting is not user-friendly, something that’s essential in getting people to ‘test’ frequently and answer honestly. Answering the same 20 questions on a regular basis can get tedious, as can trying to determine whether something is a ‘minor problem’ or a ‘moderate problem’.

In a perfect world, we’d be able to measure DREWB, but we’re not there yet. My guess is that if we figure out how, it will be based on a lot of information (e.g., activity level, stress, heart rate variability) that we can already collect.

Do you have any ideas on how we can measure DREWB? If we could easily measure DREWB would this value be helpful to you or your patients? How would you use this information? Please share your ideas in the comments below.

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