Use of remote monitoring with continuous glucose monitoring in young children with Type 1 diabetes: the parents’ perspective

Abstract

Aim Remote monitoring with continuous glucose monitoring (CGM) in children with Type 1 diabetes mellitus has recently become available, but little is known about caregivers’ experiences of its use, particularly in younger children. The aim of this study was to explore parents’ everyday experiences of using this technology. Methods The parents of children with Type 1 diabetes diagnosed for > 1 year, aged 2–12 years were invited to participate in a semi‐structured interview. Interviews were the second phase of a randomized cross‐over study using standard insulin therapy with or without CGM and remote monitoring for two 3‐month periods. Open‐ended questions were used to explore parents’ real‐life experiences of the remote monitoring and CGM system. Interviews were analysed using thematic analysis. Results Five themes related to remote monitoring emerged: (i) impact on sleep quality for the parents, (ii) peace of mind, (iii) impact on anxiety, (iv) freedom and confidence for the parents and children, and (v) impact on relationships. Furthermore, parents reported on themes related to CGM in general, such as better understanding of how to manage and control their child's diabetes and experiences related to physical or technical aspects. Conclusion Overall, parents of primary school children reported that using remote monitoring and CGM was a mostly beneficial experience. However, negative aspects within the themes were also reported. These findings will help to provide a structure to discuss parent and child expectations and provide targeted education at the start of using remote monitoring and CGM.

Glycemic Control Improvement in Italian Children and Adolescents With Type 1 Diabetes Followed Through Telemedicine During Lockdown Due to the COVID-19 Pandemic

“…In Italy, the widespread use of CGM and flash glucose monitoring among people with T1D allowed these patients to be remotely connected to the clinic through the cloud, but the use of these technologies in children and adolescents have also bridged the gap between school and family care capacities. Recently, it was demonstrated that parents of kindergarten and school children reported the usefulness and the effectiveness of remote monitoring and CGM to control glucose excursions (48). The COVID-19 pandemic has forced children and parents to spend many hours together at home, bringing back diabetes care to parents.…”

Parents’ experiences of caring for a young child with type 1 diabetes: a systematic review and synthesis of qualitative evidence

“…Research suggests that newer technologies, such as continuous glucose monitors and closedloop systems, are likely to help further ease the burden of diabetes management. For example, use of continuous glucose monitors may lessen parental anxiety due to the device alerting them to hypo-and hyperglycaemia [41], while those able to monitor their child's glucose data remotely may experience improved sleep and greater lifestyle freedoms [42,43]. Similarly, while user evaluations of closed-loop systems have mainly involved older participant groups with type 1 diabetes and/or their parents [44][45][46][47][48], preliminary trials involving very young children suggest that this technology can help parents feel less burdened by diabetes management tasks and facilitate better sleep [49].…”

The Quality of Life and Satisfaction with Continuous Glucose Monitoring Therapy in Children under 7 Years of Age with T1D Using the rtCGM System Integrated with Insulin Pump—A Caregivers Point of View

“…Several studies have confirmed the reduction in hypoglycemia anxiety in children using CGM both separately and pump augmented [ 17 , 20 , 21 ]. Pre-hypoglycemic alarms are a warning.…”

“…Night-time rest is disturbed by frequent alarms, the need to check blood glucose levels, and anxiety about hypoglycemia [ 20 ]. In a study conducted by Burckhardt et al, parameters assessed among caregivers of preschool children were also related to the parents’ sleep—better sleep was highlighted during CGM use [ 21 ]. In our analysis, we also noted an improvement in the sleep of caregivers.…”