Satisfaction with continuous glucose monitoring in adults and youths with Type 1 diabetes

Abstract

As frequent use of continuous glucose monitoring is associated with improved glycaemic control without increased hypoglycaemia it is important to overcome barriers, reinforce benefits and set realistic expectations for this technology in order to promote its more consistent and frequent use in individuals with Type 1 diabetes.

American Association Of Clinical Endocrinologists And American College Of Endocrinology 2016 Outpatient Glucose Monitoring Consensus Statement

“…To maintain a high frequency of use, patients and their parents require in-depth training with reinforcement, including periodic follow-up with clinicians and diabetes educators. The results of the JDRF CGM Study Group, using all the first-generation CGM devices available at that time (2007), showed that (83). DirecNet studied the efficacy and safety of CGM in children <10 years of age.…”

Diabetes Technology

“…44 Many factors are associated with likehood of discontinuing technology use, including more severe hypoglycemic events after starting the pump, 44 physical discomfort of wearing the CGM, 12 difficulty with insertion/adhesives/sensor functioning, frequency of alarms, skin reactions to sensors, and interference with physical activity. 12,45 Parents and their adolescents may perceive different reasons for nonuse; in one major CGM clinical trial, parents believed that their adolescents resisted using CGM due to body image concerns, but youth attributed nonuse to practical issues such as insertion pain and frequent alarms. 13 High-frequency CGM users perceive fewer hassles to using the technology than low users.…”

“…54 Positive user feedback for CGM includes being able to see trends in BG levels, being able to detect hypoglycemia more easily, and being able to correct out-of-range numbers. 45 Adolescents (versus other groups) do worse on CGM-they use it less, are less satisfied, are less accepting of hassles and burdens, and are less likely to meet A1c targets. 13 An exploratory study with cross-sectional data found greater parent-reported depression among children and adolescents using CGM compared to those using standard blood glucose monitoring, although adults using CGM reported less trait anxiety compared to the standard group.…”

“…While some trials report that CGM users have moderate satisfaction with the technology and experience improved quality of life, 13 this benefit may only be true for a subset of the population, such as those who more frequently monitor. 45 A recent meta-analysis of randomized control trials found no significant association between CGM use and health-related quality of life. 2 Another study of adult CGM users (over 90% with T1D), investigated impact on several domains of quality of life, and found that CGM was associated with increased perceived control over diabetes and hypoglycemia safety.…”

Clinical Use of Continuous Glucose Monitoring in Pediatrics

“…51 Naranjo et al reported in 2016 that those using pumps, CGMs, or sensor augmented pumps had more positive attitudes about diabetes technology than those on multiple daily injections and conventional glucose monitoring. 52 Among all participants in the JDRF CGM study group common barriers to continued use include insertion pain, system alarms, and body issues related to the need to wear the device, 53 although this was with early generation systems.…”