Continuous Glucose Monitoring in Adolescent, Young Adult, and Older Patients With Type 1 Diabetes

Agarwal, Shivani; Cappola, Anne R.

doi:10.1001/jama.2020.7058

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…The only caveat mentioned by some parents was insurance coverage determining their ability to continue using CGM. This finding is consistent with prior research demonstrating that insurance coverage, or lack thereof, determines whether individuals and families are able to sustain CGM use 4,25‐27 . In the United States, individuals from lower socio‐economic groups use CGM at significantly lower rates than those from higher socio‐economic groups; this relationship between socio‐economic status and CGM use is not seen in Germany where insurance and health care delivery differ from the United States 28 .…”

Section: Discussionsupporting

confidence: 89%

“…This finding is consistent with prior research demonstrating that insurance coverage, or lack thereof, determines whether individuals and families are able to sustain CGM use. 4,[25][26][27] In the United States, individuals from lower socio-economic groups use CGM at significantly lower rates than those from higher socio-economic groups; this relationship between socio-economic status and CGM use is not seen in Germany where insurance and health care delivery differ from the United States. 28 Many in the current study described the technology as a 'necessity' for their child's diabetes care that they would not want to give up.…”

Section: Subtheme Example Quotementioning

confidence: 99%

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‘I was ready for it at the beginning’: Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis

et al. 2021

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Aim: This study aimed to capture the experience of parents of youth with recent onset Type 1 diabetes who initiated use of continuous glucose monitoring (CGM) technology soon after diagnosis, which is a new practice. Methods: Focus groups and individual interviews were conducted with parents of youth with Type 1 diabetes who had early initiation of CGM as part of a new clinical protocol. Interviewers used a semi-structured interview guide to elicit feedback and experiences with starting CGM within 30 days of diagnosis, and the benefits and barriers they experienced when adjusting to this technology. Groups and interviews were audio recorded, transcribed and analysed using content analysis. Results: Participants were 16 parents (age 44.13 ± 8.43 years; 75% female; 56.25% non-Hispanic White) of youth (age 12.38 ± 4.15 years; 50% female; 50% non-Hispanic White; diabetes duration 10.35 ± 3.89 months) who initiated CGM 11.31 ± 7.33 days after diabetes diagnosis. Overall, parents reported high levels of satisfaction with starting CGM within a month of diagnosis and described a high level of reliance on the technology to help manage their child's diabetes. All participants recommended early CGM initiation for future families and were committed to continue using the technology for the foreseeable future, provided that insurance covered it. Conclusion: Parents experienced CGM initiation shortly after their child's Type 1 diabetes diagnosis as a highly beneficial and essential part of adjusting to living with diabetes. K E Y W O R D S children and adolescents, devices, health care delivery, psychological aspects What's new?• Continuous glucose monitoring (CGM) in a paediatric Type 1 diabetes population has benefits for time spent in glucose target range and parents' sleep and stress levels; introducing CGM shortly after Type 1 diabetes diagnosis is a new clinical practice.'The idea of the CGM is definitely a forever' (FG5, mother, son aged 14) '[My child will] have to use it the whole time she's in college, and I think she will continue to use it after because it's just so much more helpful for her too. We all agree it's been life-changing for us. As long as we can keep the insurance and everything covered, she'll keep using it, I'm assuming, forever' (FG3, father, daughter aged 19)Abbreviation: CGM, continuous glucose monitoring.How to cite this article: Tanenbaum ML, Zaharieva DP, Addala A, et al. 'I was ready for it at the beginning': Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis. Diabet Med.

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Section: Discussionsupporting

confidence: 89%

Section: Subtheme Example Quotementioning

confidence: 99%

‘I was ready for it at the beginning’: Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis

et al. 2021

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“…According to recent T1D Exchange data, only 10.5% of YAs with type 1 diabetes in the United States are meeting glycemic targets (50); many also experience greater frequency of acute complications (51) and substantially lower rates of diabetes device use compared with older adults (52)(53)(54). YAs endorse barriers to using diabetes devices, including physical hassles with wearing devices and not wanting devices to draw attention from others (52,55).…”

Section: Physical and Psychosocial Tollsmentioning

confidence: 99%

“…Additionally, there is evidence that insufficient insurance coverage contributes to lower diabetes technology adoption among YAs (56). Finally, the experience of life with diabetes is not equal across all YAs, as research documents racial and ethnic disparities in glycemic levels, diabetes device use, and emotional distress among YAs (53,57,58).…”

Section: Physical and Psychosocial Tollsmentioning

confidence: 99%

Competing Demands of Young Adulthood and Diabetes: A Discussion of Major Life Changes and Strategies for Health Care Providers to Promote Successful Balance

2021

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Young adults (YAs) are often faced with many new transitions and major milestones specific to their life stage. For YAs with diabetes, it can be particularly difficult to balance diabetes management with the age-typical demands of young adulthood. Clinicians can play an important role in helping YAs navigate major life changes and find balance in the competing demands of young adulthood, while protecting their health and well-being.

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“…10,11 Technological advancements in blood glucose monitoring have led to the development of continuous glucose monitoring (CGM), which provides a sustained, visible measure of variations of the individual's glucose levels in real time. 12,13 Research has shown possible treatment outcomes improvement when using CGM, 14,15 while the psychological barriers and benefits that accompany the use of CGM systems have indicated that employing this facility to form part of the diabetes care plan holds multiple benefits for the users. 16 For example, patients using CGM have an increased chance of achieving greater control over managing their blood glucose levels, which, in turn, offers the possibility of decreased levels of fear, improved quality of life and a sense of empowerment.…”

Section: Introductionmentioning

confidence: 99%

Continuous glucose monitoring empowers adolescents to take responsibility of diabetes management

Williams

Deacon

Rensburg

et al. 2023

Afr. j. prim. health care fam. med.

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Background: Managing diabetes is especially challenging for adolescents, and they often struggle to believe they can manage the condition. Illness perception has been widely associated with better diabetes management outcomes, but the influence of continuous glucose monitoring (CGM) on adolescents has been largely neglected.Aim: The study aimed to explore the illness perception of a group of adolescents living with type 1 diabetes (T1D) using CGM.Setting: The study was conducted at a medical centre that provides diabetes care services to youth living with T1D in Parktown, South Africa.Methods: A qualitative research approach using semi-structured online interviews was used to gather data that was thematically analysed.Results: Themes emerging from the data confirmed that CGM creates a sense of control over diabetes management as blood glucose measures were more visible. A sense of normalcy was established as CGM influences a new routine and a way of life, integrating diabetes into a young person’s identity. Despite the users’ awareness of being different due to diabetes management, CGM assisted in creating a sense of belonging, contributing to developing a better quality of life.Conclusion: Findings of this study support the use of CGM as a means of empowering adolescents struggling with diabetes management to achieve better treatment outcomes. The important role of illness perception in facilitating this change was also evident.Contribution: By listening to the adolescent’s voice, CGM was identified as a possible intervention to empower adolescents to improve diabetes management.

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Continuous Glucose Monitoring in Adolescent, Young Adult, and Older Patients With Type 1 Diabetes

Cited by 12 publications

References 16 publications

‘I was ready for it at the beginning’: Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis

‘I was ready for it at the beginning’: Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis

Competing Demands of Young Adulthood and Diabetes: A Discussion of Major Life Changes and Strategies for Health Care Providers to Promote Successful Balance

Continuous glucose monitoring empowers adolescents to take responsibility of diabetes management

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