Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 20;18(1):12.
doi: 10.1186/s12902-018-0239-1.

Patients' and caregivers' experiences of using continuous glucose monitoring to support diabetes self-management: qualitative study

J Lawton  1 , M Blackburn  2 , J Allen  3   4 , F Campbell  5 , D Elleri  6 , L Leelarathna  7 , D Rankin  2 , M Tauschmann  3   4 , H Thabit  7 , R Hovorka  3   4
Affiliations

Patients' and caregivers' experiences of using continuous glucose monitoring to support diabetes self-management: qualitative study

J Lawton et al. BMC Endocr Disord. .

Abstract

Background: Continuous glucose monitoring (CGM) enables users to view real-time interstitial glucose readings and provides information on the direction and rate of change of blood glucose levels. Users can also access historical data to inform treatment decisions. While the clinical and psychological benefits of CGM are well established, little is known about how individuals use CGM to inform diabetes self-management. We explored participants' experiences of using CGM in order to provide recommendations for supporting individuals to make optimal use of this technology.

Methods: In-depth interviews (n = 24) with adults, adolescents and parents who had used CGM for ≥4 weeks; data were analysed thematically.

Results: Participants found CGM an empowering tool because they could access blood glucose data effortlessly, and trend arrows enabled them to see whether blood glucose was rising or dropping and at what speed. This predicative information aided short-term lifestyle planning and enabled individuals to take action to prevent hypoglycaemia and hyperglycaemia. Having easy access to blood glucose data on a continuous basis also allowed participants to develop a better understanding of how insulin, activity and food impacted on blood glucose. This understanding was described as motivating individuals to make dietary changes and break cycles of over-treating hypoglycaemia and hyperglycaemia. Participants also described how historical CGM data provided a more nuanced picture of blood glucose control than was possible with blood glucose self-monitoring and, hence, better information to inform changes to background insulin doses and mealtime ratios. However, while participants expressed confidence making immediate adjustments to insulin and lifestyle to address impending hypoglycaemia and hypoglycaemia, most described needing and expecting health professionals to interpret historical CGM data and determine changes to background insulin doses and mealtime ratios. While alarms could reinforce a sense of hypoglycaemic safety, some individuals expressed ambivalent views, especially those who perceived alarms as signalling personal failure to achieve optimal glycaemic control.

Conclusions: CGM can be an empowering and motivational tool which enables participants to fine-tune and optimize their blood glucose control. However, individuals may benefit from psycho-social education, training and/or technological support to make optimal use of CGM data and use alarms appropriately.

Keywords: Caregiver experience; Continuous glucose monitoring; Patient experience; Qualitative; Type 1 diabetes.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study received approval from the independent Cambridge East Research Ethics Committee (REC ref. 15/EE/0324). Participants aged ≥16 years and parents or guardians of participants aged < 16 years signed informed consent; written assent was obtained from minors before study-related activities.

Consent for publication

Not applicable

Competing interests

RH reports having received speaker honoraria from Eli Lilly, Novo Nordisk and Astra Zeneca, serving on advisory panel for Eli Lilly and Novo Nordisk, receiving license fees from BBraun and Medtronic; having served as a consultant to BBraun; patents and patent applications. MT reports having received speaker honoraria from Novo Nordisk and Medtronic. LL reports having received speaker honoraria from Medtronic, Animas, Sanofi and Novo Nordisk, serving on advisory panel for Animas, Medtronic and Novo Nordisk. JL, DR, MB, JMA, DE and HT have no conflicts of interest to disclose.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Wong JC, Foster NC, Maahs DM, Raghinaru D, Bergenstal RM, Ahmann AJ, et al. Real-time continuous glucose monitoring among participants in the T1D exchange clinic registry. Diabetes Care. 2014;37:2702–2709. doi: 10.2337/dc14-0303. - DOI - PMC - PubMed
    1. Pickup JC, Freeman SC, Sutton AJ. Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data. BMJ. 2011;343:d3805. doi: 10.1136/bmj.d3805. - DOI - PMC - PubMed
    1. Battelino T, Conget I, Olsen B, Schütz-Fuhrmann I, Hommel E, Hoogma R, et al. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012;55:3155–3162. doi: 10.1007/s00125-012-2708-9. - DOI - PMC - PubMed
    1. Beck RW, Riddlesworth T, Ruedy K, Ahmann A, Bergenstal R, Haller S, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. JAMA. 2017;317:371–378. doi: 10.1001/jama.2016.19975. - DOI - PubMed
    1. Ly TT, Nicholas JA, Retterath A, Lim EM, Davis EA, Jones TW. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. JAMA. 2013;310:1240–1247. doi: 10.1001/jama.2013.277818. - DOI - PubMed

Substances