Tolerability and acceptability of real-time continuous glucose monitoring and its impact on diabetes management behaviours in individuals with Type 2 Diabetes - A pilot study

P J Taylor; C H Thompson; N D Luscombe-Marsh; T P Wycherley; G Wittert; G D Brinkworth; I Zajac

doi:10.1016/j.diabres.2019.107814

Tolerability and acceptability of real-time continuous glucose monitoring and its impact on diabetes management behaviours in individuals with Type 2 Diabetes - A pilot study

Diabetes Res Clin Pract. 2019 Sep:155:107814. doi: 10.1016/j.diabres.2019.107814. Epub 2019 Aug 14.

Authors

P J Taylor¹, C H Thompson², N D Luscombe-Marsh³, T P Wycherley⁴, G Wittert², G D Brinkworth⁵, I Zajac³

Affiliations

¹ Commonwealth Scientific and Industrial Research Organisation - Health and Biosecurity, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, University of Adelaide, Adelaide, Australia. Electronic address: https://orcid.org/0000-0001-8614-0829.
² Discipline of Medicine, Adelaide Medical School, University of Adelaide, Adelaide, Australia.
³ Commonwealth Scientific and Industrial Research Organisation - Health and Biosecurity, Adelaide, Australia.
⁴ Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia.
⁵ Commonwealth Scientific and Industrial Research Organisation - Health and Biosecurity, Sydney, Australia.

PMID: 31421138
DOI: 10.1016/j.diabres.2019.107814

Abstract

Introduction: Emerging evidence suggests us of real-time continuous glucose monitoring systems (RT-CGM), can assist to improve glucose control in Type 2 Diabetes (T2D) treatment, however the impact of these devices on patients' stress levels and behaviour is poorly understood. This study aimed to examine the effects of RT-CGM on tolerance and acceptability of device wear, stress and diabetes management and motivation to change.

Methods: Twenty adults (10 men, 10 women) with T2D (aged 60.6 ± 8.4 years, BMI 34.2 ± 4.7 kg/m²), were randomised to a low-carbohydrate lifestyle plan whilst wearing a RT-CGM or an 'offline-blinded' (Blinded-CGM) monitoring system continuously for 12 weeks. Outcomes were glycaemic control (HbA1c), weight (kg) perceived stress scale (PSS), CGM device intolerance, acceptability, motivation to change and diabetes management behaviour questionnaires.

Results: Both groups experienced significant reductions in body weight (RT-CGM -7.4 ± 4.5 kg vs. Blinded-CGM -5.5 ± 4.0 kg) and HbA1c (-0.67 ± 0.82% vs. -0.68 ± 0.74%). There were no differences between groups for perceived stress (P = 0.47) or device intolerance at week 6 or 12 (both P > 0.30). However, there was evidence of greater acceptance of CGM in the RT-CGM group at week 12 (P = 0.03), improved blood glucose monitoring behaviour in the RT-CGM group at week 6 and week 12 (P ≤ 0.01), and a significant time x group interaction (P = 0.03) demonstrating improved diabetes self-management behaviours in RT-CGM.

Conclusion: This study provides preliminary evidence of improved behaviours that accompany RT-CGM in the context of diabetes management and glucose self-monitoring. RT-CGM may provide an alternative approach to glucose management in individuals with T2D without resulting in increased disease distress.

Keywords: Acceptability; Continuous glucose monitoring; Tolerance; Type 2 diabetes.

MeSH terms

Blood Glucose Self-Monitoring / methods*
Diabetes Mellitus, Type 2 / blood*
Female
Healthy Lifestyle / physiology*
Humans
Male
Middle Aged
Pilot Projects