title: Real-time continuous glucose monitoring in type 1 diabetes: a qualitative framework analysis of patient narratives.
abstract: OBJECTIVE
  This study analyzed narratives about experiences of real-time continuous glucose monitoring (CGM) in people with type 1 diabetes.
  
  
  METHODS
  People with type 1 diabetes using CGM and caregivers completed an online survey. Questions included duration of CGM, frequency of sensor wear, funding, and a free narrative about experiences or views about CGM. We used qualitative framework analysis to analyze 100 responses; 50% of participants were aged ≥ 18 years.
  
  
  RESULTS
  Most participants (87%) used CGM with insulin pump therapy, 71% used sensors ≥ 75% of the time, and 66% received funding for CGM from the National Health Service. Four themes were identified: 1) metabolic control, 2) living with CGM (work and school, sleep, exercise, nutrition, frequency of self-monitoring of blood glucose [SMBG]), 3) psychological issues and patient/caregiver attitudes, and 4) barriers to CGM use (technical issues, financial issues, attitudes of healthcare professionals toward CGM). Despite some hassles, experiences were overwhelmingly positive, with improved glycemic control, diet and exercise management, quality of life, and physical and psychological well-being, as well as reduced frequency of SMBG. Technical problems included sensor inaccuracy and unreliability, and "alarm fatigue." The advantages of CGM used with an insulin pump with automatic suspension of insulin delivery during hypoglycemia were recorded by several participants, noting reduced hypoglycemia frequency and fear of nocturnal hypoglycemia.
  
  
  CONCLUSIONS
  Patient and caregiver narratives indicate that CGM is a valuable addition to diabetes care for many with type 1 diabetes.
authors.affiliation: Diabetes Research Group, King's College London School of Medicine, Guy's Hospital, London, U.K. john.pickup@kcl.ac.uk.
authors.forename: John C
authors.initials: JC
authors.lastname: Pickup
authors.affiliation: INPUT Patient Advocacy, London, U.K.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ford Holloway
authors.affiliation: Social Care Workforce Research Unit, School of Social Science and Public Policy, King's College London, London, U.K.
authors.forename: Kritika
authors.initials: K
authors.lastname: Samsi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000523:psychology; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D033262:Narration; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin