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Initial experiences of adolescents and young adults with type 1 diabetes and high-risk glycemic control after starting flash glucose monitoring - a qualitative study

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Abstract

Purpose

This study explored early experiences with a flash glucose monitoring system among adolescents and young adults with type 1 diabetes and high-risk glycemic control.

Methods

Adolescents and young adults with high-risk glycemic control (HbA1c ≥ 75 mmol/mol (9.0%) in the previous 6 months) who had recently commenced on flash glucose monitoring as part of a trial took part in a semi-structured interview exploring their experiences with the technology. All interviews were recorded, transcribed and analyzed using an inductive approach.

Results

Fifteen interviews were conducted. Overall, participants enjoyed flash glucose monitoring and planned to continue using their system. Key findings included flash glucose monitoring reduced diabetes management burden and increased glucose monitoring. Other impacts of flash glucose monitoring use included perceived improved mood and energy, increased capacity for physical activity and less parental conflict. While participants reported healthier glycemic control, participants’ mean interstitial glucose level remained above the target range of 3.9–10.0 mmol/L (70–180 mg/dL) over the first month of flash glucose monitoring. Common challenges included premature sensor loss and decreased scanning over the first month of use.

Conclusions

Flash glucose monitoring may be an acceptable self-management tool to increase monitoring frequency in adolescents and young adults with type 1 diabetes and high-risk glycemic control, with the potential to improve long-term glycemic control. Initial support efforts should focus on practical strategies to prolong sensor wear and motivate frequent scanning as well as education on interpreting glucose data and making informed treatment decisions to maximize the benefits of this technology.

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Acknowledgements

The authors wish to thank the participants for their involvement in this research.

Funding

This work was supported by Cure Kids (grant number 3582), Dunedin School of Medicine, and New Zealand Society for the Study of Diabetes (NZSSD). Funders were not involved in the study design; in the collection, analysis and interpretation of data; in writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Sara Boucher, Miranda Blackwell, Barbara Galland, Paul Tomlinson & Benjamin Wheeler

  2. Department of Paediatrics, University of Otago, Floor 3, Terrace House, 4 Oxford Terrace, Christchurch, 8011, New Zealand

    Martin de Bock

  3. Canterbury District Health Board, 211 Blenheim Rd, Riccarton, Christchurch, 8041, New Zealand

    Martin de Bock

  4. Faculty of Health, Sport and Human Performance, University of Waikato, Gate 1, Knighton Road, Hamilton, 3240, New Zealand

    Hamish Crocket

  5. Department of Paediatrics and Child Health, University of Otago, PO Box 7343, Newtown, Wellington, 6242, New Zealand

    Esko Wiltshire

  6. Capital and Coast District Health Board, Riddiford St, Newtown, Wellington, 6021, New Zealand

    Esko Wiltshire

  7. Southern District Health Board, Kew Rd, Kew, Invercargill, 9812, New Zealand

    Paul Tomlinson

  8. Southern District Health Board, 201 Great King Street, Dunedin, 9016, New Zealand

    Jenny Rayns & Benjamin Wheeler

Authors
  1. Sara Boucher
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  9. Benjamin Wheeler
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Contributions

SB contributed to the concept and design, acquisition of data, analysis and interpretation of the data, drafting and revising the article. MB contributed to the acquisition of data, analysis and interpretation of the data, drafting and revising the article. BG contributed to the concept and design, supervising acquisition of data, and revising the article critically for important intellectual content. MdB, EW, PT and JR contributed to the concept and design, and revising the article for important intellectual content. HC contributed to the design, interpretation of the data, and revising the article for important intellectual content. BW contributed to the concept and design, supervising acquisition of data, interpretation of the data, drafting and revising the article. All authors contributed to editing the final manuscript and approved it for submission.

Corresponding author

Correspondence to Benjamin Wheeler.

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Boucher, S., Blackwell, M., Galland, B. et al. Initial experiences of adolescents and young adults with type 1 diabetes and high-risk glycemic control after starting flash glucose monitoring - a qualitative study. J Diabetes Metab Disord 19, 37–46 (2020). https://doi.org/10.1007/s40200-019-00472-5

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