. 2021 Oct:180:109048.

doi: 10.1016/j.diabres.2021.109048. Epub 2021 Sep 14.

Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM

Molly L Tanenbaum¹, Laurel H Messer², Christine A Wu³, Marina Basina⁴, Bruce A Buckingham⁵, Danielle Hessler⁶, Shelagh A Mulvaney⁷, David M Maahs⁸, Korey K Hood⁹

Affiliations

¹ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: mollyt@stanford.edu.
² University of Colorado Anschutz, Barbara Davis Center for Childhood Diabetes, Aurora, CO, USA. Electronic address: laurel.messer@cuanschutz.edu.
³ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA. Electronic address: cawu@stanford.edu.
⁴ Stanford Diabetes Research Center, Stanford, CA, USA; Division of Endocrinology, Gerontology, & Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: mbasina@stanford.edu.
⁵ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: bbendo@stanford.edu.
⁶ Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA. Electronic address: danielle.hessler@ucsf.edu.
⁷ Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA; School of Nursing, Vanderbilt University, Nashville, TN, USA. Electronic address: shelagh.mulvaney@vanderbilt.edu.
⁸ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: dmmaahs@stanford.edu.
⁹ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: kkhood@stanford.edu.

PMID: 34534592
PMCID: PMC8578423
DOI: 10.1016/j.diabres.2021.109048

Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM

Molly L Tanenbaum et al. Diabetes Res Clin Pract. 2021 Oct.

. 2021 Oct:180:109048.

doi: 10.1016/j.diabres.2021.109048. Epub 2021 Sep 14.

Authors

Molly L Tanenbaum¹, Laurel H Messer², Christine A Wu³, Marina Basina⁴, Bruce A Buckingham⁵, Danielle Hessler⁶, Shelagh A Mulvaney⁷, David M Maahs⁸, Korey K Hood⁹

Affiliations

¹ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: mollyt@stanford.edu.
² University of Colorado Anschutz, Barbara Davis Center for Childhood Diabetes, Aurora, CO, USA. Electronic address: laurel.messer@cuanschutz.edu.
³ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA. Electronic address: cawu@stanford.edu.
⁴ Stanford Diabetes Research Center, Stanford, CA, USA; Division of Endocrinology, Gerontology, & Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: mbasina@stanford.edu.
⁵ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: bbendo@stanford.edu.
⁶ Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA. Electronic address: danielle.hessler@ucsf.edu.
⁷ Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA; School of Nursing, Vanderbilt University, Nashville, TN, USA. Electronic address: shelagh.mulvaney@vanderbilt.edu.
⁸ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: dmmaahs@stanford.edu.
⁹ Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford, CA, USA. Electronic address: kkhood@stanford.edu.

PMID: 34534592
PMCID: PMC8578423
DOI: 10.1016/j.diabres.2021.109048

Abstract

Aims: The purpose of this study was to explore preferences that adults with type 1 diabetes (T1D) have for training and support to initiate and sustain optimal use of continuous glucose monitoring (CGM) technology.

Methods: Twenty-two adults with T1D (M age 30.95 ± 8.32; 59.1% female; 90.9% Non-Hispanic; 86.4% White; diabetes duration 13.5 ± 8.42 years; 72.7% insulin pump users) who had initiated CGM use in the past year participated in focus groups exploring two overarching questions: (1) What helped you learn to use your CGM? and (2) What additional support would you have wanted? Focus groups used a semi-structured interview guide and were recorded, transcribed and analyzed.

Results: Overarching themes identified were: (1) "I got it going by myself": CGM training left to the individual; (2) Internet as diabetes educator, troubleshooter, and peer support system; and (3) domains of support they wanted, including content and format of this support.

Conclusion: This study identifies current gaps in training and potential avenues for enhancing device education and CGM onboarding support for adults with T1D. Providing CGM users with relevant, timely resources and attending to the emotional side of using CGM could alleviate the burden of starting a new device and promote sustained device use.

Keywords: Adults; Continuous glucose monitoring; Health care delivery; Psychosocial aspects; Telehealth; Type 1 diabetes.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: LHM has received speaking/consulting honoraria from Dexcom Inc, Tandem Diabetes, Clinical Sensors and Capillary Biomedical, and is a contracted trainer for Medtronic Diabetes. BAB reports receiving grant support and advisory board fees from Medtronic Diabetes and ConvaTec, grant support and presentation fees from Insulet, advisory board fees from NovoNordisk and Profusa, grant support from Eli Lilly, grant support and equipment from Dexcom, and holding patent 61,197,230 on a hypoglycemia prediction algorithm. DMM has had research support from the NIH, JDRF, NSF, and the Helmsley Charitable Trust and his institution has had research support from Medtronic Diabetes, Dexcom, Insulet, Bigfoot Biomedical, Tandem, and Roche. DMM has also consulted for Abbott, the Helmsley Charitable Trust, Sanofi, Novo Nordisk, Eli Lilly, Medtronic, and Insulet. KKH has received consulting fees from Lifescan Diabetes Institute and MedIQ and an investigator-initiated grant from Dexcom, Inc. MLT, CAW, MB, DH and SM have no conflicts to disclose.

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Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM

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Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM

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