medwireNews: Sharing continuous glucose monitoring (CGM) data with a chief follower has multiple quality of life (QoL) and health benefits for people with type 1 diabetes, a study shows.
“Of note, the largest and most pervasive affective changes were linked to hypoglycemic concerns,” the researchers report in Diabetes Technology & Therapeutics.
According to responses on the Hypoglycemic Confidence Scale, using the data-sharing app with the Dexcom G5 or G6 system helped 89.4% of the 302 study participants to become more confident in their ability to avoid or manage hypoglycemia. And of the seven subscales of the 28-item Diabetes Distress Scale for adults with type 1 diabetes, the greatest change was seen for hypoglycemia distress, with 60.6% of the participants reporting an improvement.
Also, 42.7% reported an improvement in management distress and 36.1% in overall diabetes distress. And over half (54.3%) of the study participants recorded increased general wellbeing on the WHO-5 scale.
Improved QoL outcomes were independently associated with three positive behaviors of the chief follower, who for a majority (51.9%) was the spouse or partner of the person with diabetes. These were celebrating with the CGM user when things were going well, offering encouragement when the person with diabetes was struggling with their glucose management, and having a clear discussion about how best to respond to out-of-range blood glucose values. These three behaviors were reported by 57.3%, 69.9%, and 69.5% of study participants, respectively.
More than half of the respondents said that their chief follower checked their blood glucose levels multiple times per day, and, encouragingly, almost all (92.4%) said that their chief follower knew what was required if the person with diabetes was hypoglycemic.
The study participants were an average age of 43 years and were for the most part White (88%), female (60%), and well educated (58%). More than half (58%) had more than one follower.
Researchers William Polonsky (Behavioral Diabetes Institute, San Diego, California, USA) and Addie Fortmann (Scripps Whittier Diabetes Institute, La Jolla, California, USA) found that, for the majority of people, data sharing resulted in increased peace of mind for both the person with diabetes and their chief follower. It increased the follower’s understanding of diabetes, made the person with diabetes feel less alone with their condition, and, for a substantial minority, even strengthened the couple’s relationship.
On the downside, 17.6% of people felt that their chief follower now bothered them too frequently about their glucose control. Thus, 23.5% said they felt more judged than previously, and 9.3% felt data sharing had caused tension in their relationship.
“Despite few participants reporting that QoL or health outcomes had worsened, it was apparent that negative aspects of data sharing exist and that these should be examined further,” write the researchers.
They conclude that people with diabetes benefit most from CGM data sharing when they and their chief follower “are operating together as a team.”
This means the CGM user’s followers “are seen as providing kudos and appropriate support, while remaining respectful of personal boundaries,” write Polonsky and Fortmann. “When this does not occur, followers may be seen as spies, judges, or people who are trying to control the actions of the [real time]-CGM user.”
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