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

February 3: Dr. Guzman (BDI’s Director of Clinical Education) will moderate ADA’s “Diabetes 101: Case Management Webinar”.

February 11: 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.

February 22: Time for another T1D meet-up! GrownupT1Ds, a wonderful nonprofit that organizes fun social events for adults with type 1 diabetes here in southern California and now spreading to other cities across the United States. The next one will be at 1 pm at Hooleys Public House, 5500 Grossmont Center Dr, La Mesa, CA. This event is free, but space is limited. Please RSVP at www.grownupt1ds.org

On April 18, 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.