Does Continuous Glucose Monitoring Use Prompt Greater Engagement in Self-Management? A Randomized Controlled Trial Focusing on Adults With Type 2 Diabetes

Authors: William H Polonsky, Emily C Soriano, Fleur Levrat-Guillen, Mariya Chichmarenko, Haley Sandoval, Alessandra Bastian, Addie L Fortmann, Andrew Kwist, Michael Vallis

Abstract

Background: Continuous glucose monitoring (CGM) promotes glycemic benefits in adults with type 2 diabetes (T2D), including insulin users as well as noninsulin users, often with minimal professional support. To investigate whether these benefits may stem from increased user engagement in self-management, we conducted a randomized controlled trial comparing the impact of CGM versus self-monitoring of blood glucose (SMBG) on self-reported engagement and HbA1c in CGM-naïve adults with T2D.

Methods: Potential participants completed the Impact of Glucose Monitoring on Self-Management Scale (IGMSS) and an HbA1c home test to confirm eligibility (>7.5%). N = 110 eligible participants were randomized to receive a FreeStyle Libre 3 (CGM arm) or a FreeStyle Precision Neo Blood Glucose Monitoring System (SMBG arm). The IGMSS and HbA1c home test were repeated after three months. Latent change score models estimated group differences in outcomes over time.

Results: CGM users reported significantly greater engagement with T2D self-management than SMBG users (IGMSS total b = 0.61, P < .001), including greater gains on all three major subscales, capability (b = 0.76, P < .001), opportunity (b = 0.46, P = .001), and motivation (b = 0.66, P < .001). CGM users also saw a significant HbA1c drop of ~1% (9.2% to 8.3%, P < .001, d = .65), with less than half the reduction in SMBG users (8.9% to 8.4%, P = .065, d = .30). However, the effect of group on HbA1c change did not reach statistical significance (P = .170), likely due to limited sample size. Conclusions: These findings suggest that introducing CGM to adults with T2D heightens users’ engagement with their own diabetes care and also improves glycemic control more than providing SMBG.

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

Source: Does Continuous Glucose Monitoring Use Prompt Greater Engagement in Self-Management? A Randomized Controlled Trial Focusing on Adults With Type 2 Diabetes – PubMed

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BDI Monthly Events

November 12: 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.

November 15: Time for another T1D meet-up! GrownupT1Ds, a wonderful nonprofit here in southern California, which organizes fun social events for adults with type 1 diabetes here in southern California. This next one will be at 2 pm at Brewery X, 3191 E La Palma Ave, Anaheim, CA. This event is free, but space is limited. Please RSVP at www.grownupt1ds.orgmeetings/annual/info

November 7: Dr Guzman (BDI Director of Clinical Education) and Dr Fisher (BDI Director of Research) will lead an adapted DD-ASSIST Program for the clinical team the UCSF Diabetes and Pregnancy Program. The goal of this program is to help the team be able to assess and address pregnancy-related diabetes distress as part of their routine care.