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Better Type 1 Diabetes Management: DIY-CGM’s Promise


Exploring the Benefits of DIY-CGM in Type 1 Diabetes Management

A recent small-scale study involving patients with type 1 diabetes (T1D) has unveiled the potential advantages of smartwatch-integrated, do-it-yourself continuous glucose monitoring (DIY-CGM) compared to intermittently scanned CGM (isCGM).

Published in the journal Diabetic Medicine, this qualitative study indicates that DIY-CGM, a more cost-effective alternative to traditional real-time continuous glucose monitoring (rt-CGM), may alleviate the burden of diabetes management. Patients reported enhanced accessibility to glucose data and reduced self-management challenges with DIY-CGM when compared to isCGM.

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While major guidelines recommend rt-CGM for T1D management, its global adoption has been hindered by regulatory and cost-related obstacles. DIY-CGM offers an affordable alternative utilizing third-party devices that transmit data via Bluetooth to smartphones or smartwatches, utilizing the first-generation isCGM (the FreeStyle Libre Flash Glucose Monitoring System).

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This study aimed to bridge a knowledge gap by examining the experiences of T1D patients using DIY-CGM and discerning the perceived benefits and drawbacks from their perspective. It also explored the emerging role of wearable technologies, such as smartwatches, in diabetes care.

Uncovering Patient Perspectives

The research enrolled participants from a multi-center, randomized, controlled, crossover clinical trial evaluating DIY-CGM with smartwatch integration versus isCGM in individuals aged 16 to 69 years. A total of 12 participants, who completed the intervention arm of the primary study, took part in semi-structured virtual interviews, achieving a 100% response rate.

The participants’ responses were categorized into three main themes and seven subcategories: the evolution of DIY-CGM use, device trust, and challenging user experiences.

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Overall, participants reported improved glycemic control and an enhanced quality of life with Do It Yourself-CGM in comparison to isCGM. It reduced the disease burden as patients no longer needed to scan their isCGM sensors when employing DIY-CGM.

The alarm feature and trend information provided insights into reduced glycemic variability during various times of the day, and the integration with smartwatches allowed discreet access to glucose data.

Although most participants had positive experiences using smartwatches for glucose data, some preferred using their phones alone. Technological malfunctions related to device connectivity were reported by many patients, but no serious diabetes-related incidents resulted from these malfunctions.

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Despite these challenges, there was a high level of trust in DIY-CGM, with all participants reporting some degree of trust in the technology. Nearly half of the patients expressed complete trust, while almost half reported trust on most occasions.

The study acknowledges certain limitations, including the context of participants being part of a clinical trial, which may not fully represent the broader population using Do It Yourself-CGM. The study also had a two-month duration, warranting longer-term investigations to assess the advantages and disadvantages of DIY-CGM.

Nonetheless, the findings suggest that DIY-CGM could serve as an acceptable and convenient form of real-time continuous glucose monitoring for adults in cost-constrained environments.

The authors came to the following conclusion: “As long as isCGM remains cheaper than most commercial rt-CGM, DIY-CGM has the potential to increase access to rt-CGM use,” especially if more clinicians and nurse specialists become familiar with its use. “A previous study has shown that rt-CGM can reduce inequities in glucose outcomes based on socioeconomic status or ethnicity, and therefore a lower-cost Do It Yourself-CGM has a role as an interim measure