How CGM Boosts Self-Efficacy, Engagement With Self-Management, and Clinical Outcomes in Adults With Type 2 Diabetes: A Mixed-Methods Study

Authors: Emily C. Soriano, William Polonsky, Taylor L. Clark, Mariya Chichmarenko, Haley Sandoval, Alessandra Bastian, Addie L. Fortmann , Andrew Kwist, Fleur Levrat-Guillen

Abstract

OBJECTIVE

Continuous glucose monitoring (CGM) improves type 2 diabetes (T2D) outcomes, but how this is achieved remains unclear. We explored how CGM affects diabetes-related attitudes and behavior, and whether these changes are associated with engagement in self-management and glycemic outcomes.

RESEARCH DESIGN AND METHODS

T2D adults who completed the FreeStyle Libre 3 (FSL3) arm of a 3-month randomized controlled trial were invited to participate in semistructured interviews. Thematic analysis was used to identify attitudinal and behavioral themes. Linear regression tested whether themes were associated with changes in self-reported engagement and HbA_1c.

RESULTS

Thirty-one of 47 (66%) FSL3 arm participants were interviewed. Three attitudinal themes emerged: greater awareness, effective decision-making, and enhanced self-efficacy. Behavioral themes included diet modifications, physical activity changes, and medication-taking changes. Participants reporting enhanced self-efficacy (65% of the sample) showed greater HbA_1c reductions (1.5% [16 mmol/mol] vs. 0.1% [1 mmol/mol], P = 0.004) and greater gains in engagement (0.5 vs. 0.1, P = 0.005) than those who did not.

CONCLUSIONS

CGM use is associated with meaningful improvements in diabetes-related attitudes and behaviors. Enhanced diabetes self-efficacy, in particular, may be a key pathway by which CGM improves glycemic outcomes and engagement in self-management among adults with T2D.

Keywords: CGM; engagement; self-management; type 2 diabetes.

Source: How CGM Boosts Self-Efficacy, Engagement With Self-Management, and Clinical Outcomes in Adults With Type 2 Diabetes: A Mixed-Methods Study | Diabetes, Obesity, and Cardiometabolic CARE | American Diabetes Association

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BDI Monthly Events

June 5 - 8: It will be a busy time at the American Diabetes Association’s 85th Scientific Sessions (New Orleans, LA), with new projects to be developed, old friends to see, and much to learn. Dr. Polonsky, BDI President, will serve a co-author on four poster presentations

May 13: BDI hosts the San Diego-wide, monthly case consultation meeting (for mental health professionals working in the field of diabetes). Contact us at [email protected] if you are in the greater San Diego area and would like further information about this program.

August 14 - 16. Taking Control of Your Diabetes (TCOYD) will be hosting the in-person ONE event, an amazing weekend experience here in San Diego for more than 500 people with type 1 diabetes and their loved ones. Dr. Polonsky is honored to be one of the presenters, and we will hope to see many of you there. There are still a few spaces left, so if you’d like to know more, please visit

On October 24, BDI will host a live, one-day, CME workshop: Engaging the Disengaged: Innovative Strategies for Promoting Behavior Change in Diabetes. Run by Dr. Polonsky (BDI President) and Dr. Guzman (BDI Clinic Director), Participants will deepen their skills in recognizing and addressing common barriers to effective self-care and cardiometabolic medication initiation and maintenance, while fostering respectful, stigma-free clinical encounters.