Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: A systematic review of qualitative studies

Patrizia Natale; Sharon Chen; Clara K Chow; Ngai Wah Cheung; David Martinez-Martin; Corinne Caillaud; Nicole Scholes-Robertson; Ayano Kelly; Jonathan C Craig; Giovanni Strippoli; Allison Jaure

doi:10.1111/1753-0407.13454

Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: A systematic review of qualitative studies

J Diabetes. 2023 Dec;15(12):1048-1069. doi: 10.1111/1753-0407.13454. Epub 2023 Aug 8.

Authors

Patrizia Natale^{1

2

3}, Sharon Chen^{1

4}, Clara K Chow^{5

6}, Ngai Wah Cheung^{5

6

7}, David Martinez-Martin^{8

9}, Corinne Caillaud^{10

11}, Nicole Scholes-Robertson^{1

4}, Ayano Kelly^{4

12

13

14}, Jonathan C Craig¹⁵, Giovanni Strippoli^{1

2}, Allison Jaure^{1

4}

Affiliations

¹ Sydney School of Public Health, The University of Sydney, Sydney, Australia.
² Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy.
³ Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
⁴ Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
⁵ Westmead Applied Research Centre, Westmead Hospital, Sydney, Australia.
⁶ Sydney Medical School, The University of Sydney, Sydney, Australia.
⁷ Westmead Clinical School, Westmead Hospital, Sydney, Australia.
⁸ The University of Sydney Nano Institute (Sydney Nano), The University of Sydney, Sydney, Australia.
⁹ School of Biomedical Engineering, The University of Sydney, Sydney, Australia.
¹⁰ Charles Perkins Centre, The University of Sydney, Sydney, Australia.
¹¹ School of Medical Sciences, The University of Sydney, Sydney, Australia.
¹² School of Health and Medicine, South Western Sydney Campus, University of New South Wales, Sydney, Australia.
¹³ Rheumatology Department, Liverpool Hospital, Sydney, Australia.
¹⁴ Ingham Institute of Applied Medical Research, Sydney, Australia.
¹⁵ College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Abstract
in English, Chinese

Aims: Blood glucose control is central to the management of diabetes, and continuous glucose monitoring (CGM) improves glycemic control. We aimed to describe the perspectives of people with diabetes using CGM.

Materials and methods: We performed a systematic review of qualitative studies.

Results: Fifty-four studies involving 1845 participants were included. Six themes were identified: gaining control and convenience (reducing pain and time, safeguarding against complications, achieving stricter glucose levels, and sharing responsibility with family); motivating self-management (fostering ownership, and increasing awareness of glycemic control); providing reassurance and freedom (attaining peace of mind, and restoring social participation); developing confidence (encouraged by the endorsement of others, gaining operational skills, customizing settings for ease of use, and trust in the device); burdened with device complexities (bewildered by unfamiliar technology, reluctant to rely on algorithms, overwhelmed by data, frustrated with malfunctioning and inaccuracy, distressed by alerts, and bulkiness of machines interfering with lifestyle); and excluded by barriers to access (constrained by cost, lack of suppliers).

Conclusions: CGM can improve self-management and confidence in patients managing diabetes. However, the technical issues, uncertainty in readings, and cost may limit the uptake. Education and training from the health professionals may help to reduce the practical and psychological burden for better patient outcomes.

目的:血糖控制是糖尿病管理的核心，连续血糖监测(CGM)可改善血糖控制。我们的目的是描述糖尿病患者使用CGM的观点方法:我们对定性研究进行了系统综述结果:纳入了54项研究，涉及1845名参与者。确定了六个主题:获得控制和便利(减少疼痛和时间，防止并发症，实现更严格的血糖控制，与家人分担责任)；激励自我管理(培养主人翁意识，提高血糖控制意识)；提供保证和自由(获得安心，恢复社会参与)；培养信心(受到他人认可的鼓励，获得操作技能，定制设置以方便使用，并对设备充满信任)；设备复杂性带来的负担(被不熟悉的技术所困扰，不愿意依赖算法，被数据压倒，对故障和不准确感到沮丧，被警报困扰，机器笨重干扰了生活方式)；被准入障碍排除(受到成本和缺乏供应商的限制) 结论:CGM可以改善患者糖尿病的自我管理和信心。然而，技术问题、读数的不确定性和成本可能限制其应用。卫生专业人员的教育和培训可能有助于减轻患者的实际和心理负担，以获得更好的患者结果.

Keywords: 1型糖尿病; 2型糖尿病; continuous glucose monitoring; insulin pump therapy; patient experiences; type 1 diabetes; type 2 diabetes; 患者体验; 胰岛素泵治疗; 连续血糖监测.

Publication types

Systematic Review

MeSH terms

Blood Glucose
Blood Glucose Self-Monitoring
Continuous Glucose Monitoring
Diabetes Mellitus, Type 1* / drug therapy
Humans
Hyperinsulinism*
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Insulin Infusion Systems
Insulins*
Patient Outcome Assessment
Quality of Life

Substances

Blood Glucose
Insulins
Insulin
Hypoglycemic Agents

Grants and funding

The University of Sydney Robinson Fellowship

Abstract in English, Chinese

Publication types

MeSH terms

Substances

Grants and funding

Abstract
in English, Chinese