Perceptions and Experiences of Using Intermittently Scanned Continuous Glucose Monitoring among Youth Ages 13–20 Years with Type 1 Diabetes and Above Recommended HbA1c: A Qualitative Study ^†

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.