The use of continuous glucose monitoring systems in a pediatric population with type 1 diabetes mellitus in real-life settings: the AWeSoMe Study Group experience

Rachmiel, Marianna; Landau, Zohar; Boaz, Mona; Aronovitch, Kineret Mazor; Loewenthal, Neta; Ben‐Ami, Michal; Levy‐Shraga, Yael; Modan‐Moses, Dalit; Haim, Alon; Abiri, Shirli; Pinhas‐Hamiel, Orit

doi:10.1007/s00592-014-0643-6

Cited by 43 publications

(37 citation statements)

References 18 publications

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“…Specifically, at 3 months, 71 youths (86%) were using CGM at least 75% of the time while at 12 months, only 32 youths were using CGM at least 75% of the time. 41 These data suggest that other patient characteristics may have a greater influence on CGM use than cost. For example, although not specifically predictive of frequency of use, other studies have found relations between better outcomes using CGM and patient-report of greater motivation for glycemic control, better coping resources, a better understanding of how to use CGM data, and greater family support, suggesting the opposites of all of these could be additional barriers to use.…”

Section: Real-time Cgmmentioning

confidence: 93%

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Adherence to Glycemic Monitoring in Diabetes

Patton

2015

J Diabetes Sci Technol

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Glucose monitoring either by self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) plays an important role in diabetes management and in reducing risk for diabetes-related complications. However, despite evidence supporting the role of glucose monitoring in better patient health outcomes, studies also reveal relatively poor adherence rates to SMBG and CGM use and numerous patient-reported barriers. Fortunately, some promising intervention strategies have been identified that promote at least short-term improvements in patients' adherence to SMBG. These include education, problem solving, contingency management, goal setting, cognitive behavioral therapy, and motivational interviewing. Specific to CGM, interventions to promote greater use among patients are currently under way, yet one pilot study provides data suggesting better maintenance of CGM use in patients showing greater readiness for behavior change. The purpose of this review is to summarize the literature specific to glucose monitoring in patients with diabetes focusing specifically on current adherence rates, barriers to monitoring, and promising intervention strategies that may be ready to deploy now in the clinic setting to promote greater patient adherence to glucose monitoring. Yet, to continue to help patients with diabetes adhere to glucose monitoring, future research is needed to identify the treatment strategies and the intervention schedules that most likely lead to long-term maintenance of optimal glycemic monitoring levels.

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Section: Real-time Cgmmentioning

confidence: 93%

“…10,11 Cost of CGM supplies has also been identified as a barrier to use. 11,41 Indeed, cost may be a formidable barrier in countries with limited insurance reimbursement for CGM. However, a recent study tested the impact of cost on CGM frequency of use in Israel, where CGM is covered by their national health insurance program.…”

Section: Real-time Cgmmentioning

confidence: 99%

Adherence to Glycemic Monitoring in Diabetes

Patton

2015

J Diabetes Sci Technol

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“…The costs of devices were prohibitive as well and were not well covered by national or private insurance plans. Even when the costs of the devices are covered, 57 % of patients at 12 months no longer used sensors [4]. Consistent users tended to be younger with more frequent baseline meter glucose measurements.…”

Section: Continuous Glucose Monitoring Systemsmentioning

confidence: 93%

Technology and Type 1 Diabetes: Closed-Loop Therapies

Buckingham

2015

Curr Pediatr Rep

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The concept of a closed-loop, automated insulin delivery system, with continuous glucose sensing and insulin delivery informed by a control algorithm without patient intervention, offers the potential to decrease the burden of diabetes management and modify the significant glycemic excursions associated with conventional therapy. Closed-loop technology represents a change in the treatment paradigm for diabetes as the transition is made from primarily self-management behaviors to automated insulin therapy, potentially relieving the burden and guilt of suboptimal glucose control. The advances in this field have been rapid, and clinical trials are currently underway worldwide testing several systems in various stages of development. We have moved rapidly from inpatient research centers to supervised outpatient settings such as diabetes camps, hotels, and now to the home environment with and without remote monitoring. Recent studies and the potential impact on the care of children with type 1 diabetes are presented in this report.

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“…The authors conclude that providers should be aware that CGM is most useful in compliant patients. 51 Naranjo et al reported in 2016 that those using pumps, CGMs, or sensor augmented pumps had more positive attitudes about diabetes technology than those on multiple daily injections and conventional glucose monitoring. 52 Among all participants in the JDRF CGM study group common barriers to continued use include insertion pain, system alarms, and body issues related to the need to wear the device, 53 although this was with early generation systems.…”

Section: Special Considerations In Pediatricsmentioning

confidence: 99%