Continuous glucose monitoring in non-insulin-using individuals with type 2 diabetes: acceptability, feasibility, and teaching opportunities

Abstract

Background: Continuous glucose monitoring (CGM) has the potential to provide useful data for behavioral interventions targeting non-insulin-using, sedentary individuals with type 2 diabetes mellitus (T2DM). The aims of this study were to describe CGM in terms of (1) feasibility and acceptability and (2) dietary- and exercise-teaching events.

Methods: Cross-sectional data were analyzed from 27 non-insulin-using adults with T2DM who wore CGM for 72 h as part of a larger study on using CGM for exercise counseling in this population. Feasibility data included accuracy of entering daily self-monitored blood glucose (SMBG) readings and events (e.g., meals, exercise), sensor failures, alarms, optimal accuracy of glucose data, and download failures. Acceptability data included CGM satisfaction and wearing difficulties. Dietary- and exercise-teaching events were identified from CGM and activity monitor data.

Results: CGM graphs showed 141 dietary- and 71 exercise-teaching events. About half the participants (52%) reported difficulty remembering to enter events into CGM monitors, but most (82%) kept an accurate paper log of events. Insufficient SMBG entries resulted in 32 CGM graphs with "use clinical judgment" warnings. Eighty-three percent of missed SMBG entries were from 18 participants 55-77 years old. Missing correlation coefficients resulted from glucose concentrations varying <100 mg/dL. A majority of participants (n = 19) were willing to wear CGM again despite reporting minor discomfort at sensor site and with wearing the monitor.

Conclusions: CGM data provided several teaching opportunities in non-insulin-using adults with T2DM. Overall, CGM was acceptable and feasible. Some identified problems may be eliminated by newer technology.

FIG. 1.

CGM teaching events. Day 2 of CGM depicts glucose level decrease following physical activity in a 58-year-old white man: physical activity/exercise (), meal (♦), long-acting medication (), and SMBG ().

FIG. 2.

CGM teaching events: dietary. Day 3 of CGM depicts glucose level increases with high carbohydrate meals and some lowering of glucose levels following physical activity in a 47-year-old African American woman: physical activity/exercise (), meal (♦), long-acting medication (), and SMBG ().