Abstract
The experiences of youth with high-risk glycaemic control using intermittently scanned continuous glucose monitoring (isCGM) systems are not well known. In the context of a randomised controlled trial investigating a 6-month isCGM intervention, this sub-study aimed to explore the experiences of youth using isCGM for 6 months. Semi-structured interviews were conducted with 14 youth aged 14–20 years who had Type 1 diabetes for ≥12 months and a glycated haemoglobin (HbA1c) of ≥75 mmol/mol (≥9%) pre-isCGM intervention. Interviews were recorded, transcribed and coded using Nvivo. A thematic analytic approach was used to identify key themes overall and by comparing participants who at 6 months had: (1) experienced a ≥10 mmol/L (0.9%) reduction in HbA1c and (2) sustained scanning frequency ≥3/day to those who did not. All participants expressed a strong preference for isCGM over self-monitoring blood glucose. Overall, isCGM contributed to perceived reduced diabetes burden without a requirement for more support in diabetes management. Increased engagement with self-management, including successful changes in dosage of basal or bolus insulin and increased frequency of administration of insulin, were behaviours reported by those experiencing the greatest improvement in HbA1c (>10 mmol/L [>0.9%], n = 6). They noted feeling more energetic, thus, making it easier to maintain self-management behaviours. Most youths reported best practices, such as following prompts to rescan in 10 min and timely sensor replacement; however, most did not check capillary blood glucose levels in recommended situations. Over 6 months, youth with high-risk diabetes experienced isCGM as a useful short-term tool for overcoming diabetes burden and facilitating self-management.
Author Contributions
Conceptualization, S.E.S., H.R.C., E.J.W., M.I.d.B. and B.J.W.; methodology, S.E.S. and H.R.C.; formal analysis, S.E.S. and H.R.C.; investigation, S.E.S.; resources, E.J.W., M.I.d.B. and B.J.W.; data curation, S.E.S.; writing—original draft preparation, S.E.S. and H.R.C.; writing—review and editing, S.E.S., H.R.C., E.J.W., M.I.d.B. and B.J.W.; visualization, S.E.S. and H.R.C.; supervision, B.J.W.; project administration, S.E.S.; funding acquisition, S.E.S., E.J.W., M.I.d.B. and B.J.W. All authors have read and agreed to the published version of the manuscript.
Funding
This research was funded by Cure Kids grant number [3582] and Dunedin School of Medicine.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Health and Disability Ethics Committee (17/STH/240, 13 March 2018) and the Ngāi Tahu Research Consultation Committee.
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data are not publicly available due to their containing information that could compromise the privacy of research participants.
Conflicts of Interest
The authors declare no conflict of interest.
Trial Registration
The randomized controlled trial was prospectively registered with the Australian New Zealand Clinical Trials Registry on 5 March 2018 (ACTRN12618000320257p).
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