Acceptability of Continuous Glucose Monitoring in Free-Living Healthy Individuals: Implications for the Use of Wearable Biosensors in Diet and Physical Activity Research

Abstract

BackgroundWearable sensors have been increasingly used in behavioral research for real-time assessment and intervention purposes. The rapid advancement of biomedical technology typically used in clinical settings has made wearable sensors more accessible to a wider population. Yet the acceptability of this technology for nonclinical purposes has not been examined.ObjectiveThe aim was to assess the acceptability of wearing a continuous glucose monitor (CGM) device among a sample of nondiabetic individuals, and to compare the acceptability of a CGM between a mobile diet tracking app (MyFitnessPal) and an accelerometer.MethodsA total of 30 nondiabetic adults went through a 7-day observational study. They wore a CGM sensor, tracked their diet and physical activity using the CGM receiver and MyFitnessPal, and wore an accelerometer on their waist. After the monitoring period, they completed a 10-item survey regarding acceptability of each of the study tools. Two-tailed paired-sample t tests were conducted to examine whether the summary acceptability scores were comparable between the CGM sensor/receiver and MyFitnessPal/accelerometer.ResultsMore than 90% of the study participants agreed that the CGM sensor and receiver were easy to use (28/30 and 27/30, respectively), useful (28/30 and 29/30, respectively), and provided relevant information that was of interest to them (27/30 and 28/30, respectively). The summary acceptability scores (out of a 5-point Likert scale) were mean 4.06 (SD 0.55) for the CGM sensor, mean 4.05 (SD 0.58) for the CGM receiver, mean 4.10 (SD 0.68) for MyFitnessPal, and mean 3.73 (SD 0.76) for the accelerometer.ConclusionsThe high acceptability of using a CGM from this study suggests a great potential for using CGMs in nondiabetic adults in research settings. Although potential selection bias might contribute to the high acceptability in this study, the continued advancements in wearable sensor technology will make the barriers to tracking and collecting personal physiological data more and more minimal.

Using Continuous Glucose Monitoring to Motivate Physical Activity in Overweight and Obese Adults: A Pilot Study

“…The recruitment goal for this study was to enroll 20 participants. This sample size was chosen because of the pilot nature of the study and on the basis of previous feasibility and acceptability studies that tested technology-based tools (31,32).…”

“…In patients with type 2 diabetes, CGM-based PA counseling in intervention settings has been shown to increase PA (28,29). Incorporating CGMs into lifestyle interventions for nondiabetic individuals has also been explored (30,31). The results suggest that leveraging data from biosensors is highly promising.…”

Future Directions for Integrative Objective Assessment of Eating Using Wearable Sensing Technology

“…CGM could therefore be another method for the passive, objective detection of meal timings in future, although further research, particularly in populations without diabetes, is required. Encouragingly pilot work in the US indicates that wearing a CGM for up to a week is as acceptable as wearing accelerometer-based sensors for 7 days ( 67 ). Furthermore, our own pilot work in the UK ALSPAC-G2 cohort demonstrated that using the latest CGM devices, which no longer require finger prick tests for calibration, improves uptake of 6 days of monitoring ( 68 ).…”

Future directions for integrative objective assessment of eating using wearable sensing technology

“…Meal detection algorithms have yet to be robustly demonstrated though, and further research using CGM in populations without diabetes is required. Encouragingly, pilot work in the US indicates that wearing a CGM for up to a week is as acceptable as wearing accelerometer-based sensors for 7 days 63 . Furthermore, our own pilot work in the UK ALSPAC-G2 cohort demonstrated that using the latest CGM devices, which no longer require finger prick tests for calibration, improves uptake of 6 days of monitoring 64 .…”