Continuous glucose monitoring in non-insulin-using individuals with type 2 diabetes: acceptability, feasibility, and teaching opportunities.
BACKGROUND
Continuous glucose monitoring (CGM) has the potential to provide useful data for behavioral interventions targeting non-insulin-using, sedentary individuals with type 2 diabetes mellitus (T2DM). The aims of this study were to describe CGM in terms of (1) feasibility and acceptability and (2) dietary- and exercise-teaching events.


METHODS
Cross-sectional data were analyzed from 27 non-insulin-using adults with T2DM who wore CGM for 72 h as part of a larger study on using CGM for exercise counseling in this population. Feasibility data included accuracy of entering daily self-monitored blood glucose (SMBG) readings and events (e.g., meals, exercise), sensor failures, alarms, optimal accuracy of glucose data, and download failures. Acceptability data included CGM satisfaction and wearing difficulties. Dietary- and exercise-teaching events were identified from CGM and activity monitor data.


RESULTS
CGM graphs showed 141 dietary- and 71 exercise-teaching events. About half the participants (52%) reported difficulty remembering to enter events into CGM monitors, but most (82%) kept an accurate paper log of events. Insufficient SMBG entries resulted in 32 CGM graphs with "use clinical judgment" warnings. Eighty-three percent of missed SMBG entries were from 18 participants 55-77 years old. Missing correlation coefficients resulted from glucose concentrations varying <100 mg/dL. A majority of participants (n = 19) were willing to wear CGM again despite reporting minor discomfort at sensor site and with wearing the monitor.


CONCLUSIONS
CGM data provided several teaching opportunities in non-insulin-using adults with T2DM. Overall, CGM was acceptable and feasible. Some identified problems may be eliminated by newer technology.
Allen
Nancy A
NA
Yale University, New Haven, Connecticut, USA. nancy.a.allen@yale.edu
Fain
James A
JA
Braun
Barry
B
Chipkin
Stuart R
SR
D000328:Adult; D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D015992:Body Mass Index; D003376:Counseling; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000534:rehabilitation; D004435:Eating; D004522:Educational Status; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007239:Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D010353:Patient Education as Topic
D006442:Glycated Hemoglobin