What are the quality of life-related benefits and losses associated with real-time continuous glucose monitoring? A survey of current users

Diabetes Technol Ther. 2013 Apr;15(4):295-301. doi: 10.1089/dia.2012.0298. Epub 2013 Feb 21.

Abstract

Background: How does real-time (RT) continuous glucose monitoring (CGM) affect quality of life (QOL)? We explored the types and frequencies of diabetes-specific QOL changes resulting from RT-CGM as reported by current users and investigated what patient-reported factors predict these changes.

Subjects and methods: Current RT-CGM users (n = 877) completed an online questionnaire investigating perceived QOL benefits/losses since RT-CGM initiation and RT-CGM attitudes and behavior. Exploratory factor analysis (EFA) examined the 16 QOL benefit/loss items to identify underlying factors. Regression analyses examined associations between demographics and RT-CGM attitudes and behavior with the QOL factors emerging from the EFA.

Results: Three major QOL factors emerged: Perceived Control over Diabetes, Hypoglycemic Safety, and Interpersonal Support. QOL improvement was common for Perceived Control over Diabetes and Hypoglycemic Safety (86% and 85% of respondents, respectively), although less common for Interpersonal Support (37%). Consistent independent predictors of perceived benefits were greater confidence in using RT-CGM data (P<0.001), satisfaction with device accuracy (P ≤ 0.05) and usability (P<0.01), older age (P<0.01), more frequent receiver screen views (P<0.05), and use of multiple daily injections (Hypoglycemic Safety and Interpersonal Support, P ≤ 0.05).

Conclusions: Diabetes-specific QOL benefits resulting from RT-CGM were common. Major predictors of QOL benefits were satisfaction with device accuracy and usability and trust in one's ability to use RT-CGM data, suggesting that "perceived efficacy," for both device and self, are key QOL determinants. Psychoeducational strategies to boost confidence in using RT-CGM data and provide reasonable device expectations might enhance QOL benefits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring / methods
  • Blood Glucose Self-Monitoring / psychology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Electronic Mail
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / epidemiology
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / therapeutic use
  • Insulin Infusion Systems
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / methods
  • Monitoring, Ambulatory / psychology*
  • Patient Satisfaction
  • Quality of Life
  • Reproducibility of Results
  • Surveys and Questionnaires

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human