Pros and cons of CGM described by parents of children with diabetes
medwireNews: Continuous glucose monitoring (CGM) offers many benefits to the families of young children with type 1 diabetes but also a number of challenges that cannot always be overcome, show results of a qualitative analysis conducted in the USA.
Kellee Miller (Jaeb Center for Health Research, Tampa, Florida, USA) and colleagues explain that, according to data from the T1D Exchange, CGM use in children under 6 years of age increased from 4.4% to 44.5% in the USA between 2011 and 2016.
The researchers therefore set out “to obtain a better understanding of the current experiences” of parents with children using CGM.
The study included 55 parents (88% mothers) of children aged 1 to 7 years (mean 5.0 years), who had type 1 diabetes for at least 6 months (mean 2.4 years) and a glycated hemoglobin level below 10.5% (mean 7.9%). Of these, 85% were current CGM users and the remaining 15% had previously used the technology.
All of the parents took part in 30-minute semi-structured interviews that included questions about their experiences with blood glucose meters, insulin pumps, and CGM devices.
Following the interviews, qualitative analyses highlighted the benefits and challenges of CGM use as the two major themes among the responses, each with multiple subthemes.
The benefits of CGM use described by parents included:
- decreased worry;
- increased confidence about their child’s safety, particularly among those with children who cannot recognize or express hypoglycemic or hyperglycemic symptoms;
- improved sleep;
- greater confidence in other caregivers, especially when using remote monitoring functionality when away from children;reduced need for fingerstick blood glucose monitoring;more time spent in target glucose range; and
- more data to inform diabetes management decisions.
The most commonly reported challenges were:
- painful sensor insertions;
- difficulty in placing multiple devices on small bodies;disruptive alerts;
- lost signals resulting in data gaps;
- skin irritation and adhesive problems; and
- too much information generated by CGM and a difficulty interpreting it all.
Writing in Diabetes Technology & Therapeutics, Miller and co-authors point out that they did not have specific information on the CGM models used. They therefore believe “it is possible that those reporting technical problems may have given up using CGM based on negative experiences with early generation devices.”
Indeed, “[g]iven marked improvements in performance, insertion ease, and duration of sensor wear, it may be important to ensure families of young children receive up-to-date education about current diabetes devices,” the researchers add.
Miller et al conclude: “Attention to individual differences in parents and to temperamental differences in young children can inform clinical strategies to support families in making diabetes management decisions, and pave the way to future success of various diabetes management devices, including CGM and automated insulin delivery systems.”
By Laura Cowen
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