'It's a Balancing Act'. A Qualitative Study of the Everyday Management of Type 1 Diabetes Among People with Unexplained Persistent Hyperglycaemia.
Berit Kjærside Nielsen, Annesofie Lunde Jensen, Anna Ryberg and 3 others
PMID 40040551WHAT IT FOUND
Participants with persistent high blood sugar often chose higher readings to avoid lows.
They described lows as exhausting, embarrassing and socially risky, while diabetes felt unpredictable despite routines, sensors and clinic advice.
Key findings
01Participants prioritised higher glucose levels because low blood sugar could cause loss of control, dependence on others, shame and worry in social or family situations.
02Many described diabetes as unpredictable: glucose could rise despite insulin, and stress, trauma or grief could change how the body responded.
03Clinic communication split: some preferred data-focused advice, while others wanted personalised guidance for everyday demands such as stress, work and family life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study interviewed 19 adults from a specific clinic, so it cannot show what all people with diabetes experience. People with severe long-term complications or complex psychosocial problems were excluded, so the findings may not apply to patients whose high glucose is explained by those issues. Most interviews were by phone, which may have reduced non-verbal cues and rapport. The authors note potential selection bias from a specific clinic list and a low response rate. It describes experiences and does not report a tested intervention. The sample was recruited in Denmark, and the authors call for broader minority representation.
The easy way to misread this
Do not read participant preference for higher glucose as a safe self-management plan. The study describes their lived experience and does not test whether this choice improves or worsens long-term outcomes.