Instant glucose control could prompt lifestyle changes in people with prediabetes, study finds

The use of instant glucose monitoring could promote lifestyle changes in people with diabetes, according to a new study.

A prospective, single-arm study conducted among people with prediabetes, study results demonstrate that people with prediabetes using a flash glucose monitoring system felt that use of the system would allow them to make lifestyle changes aimed at preventing progression to diabetes, with the majority of patients stating that they would recommend its use to others with prediabetes.

“To our knowledge, this is the first study that explored the feasibility and acceptability of using [flash glucose monitoring system] sensors among people with prediabetes,” the researchers wrote. “While we confirmed that people with prediabetes were receptive to using [flash glucose monitoring system] sensors, our study endured a high uncontactable rate, which was likely due to recruiting participants from medically underserved communities and the impact of the COVID-19 pandemic.”

As continuous glucose monitoring (CGM) technology continues to advance at a rapid pace, improved systems have raised questions about potential application in populations beyond those with a diagnosis of type 1 or type 2 diabetes, including hospital settings and, currently studying, people with prediabetes. With an interest in exploring use in people with prediabetes, the current effort was designed by researchers at the University of California, Irvine as a single-arm, prospective study with the specific intent of describing the feasibility and acceptability of the sensor system. flash glucose monitoring to potentiate lifestyle changes in this patient population.

The researchers recruited patients receiving care at a pair of federally qualified health care centers and invited patients to wear flash glucose monitoring sensors for 28 days. Investigators measured viability through subject recruitment, which was assessed through subject compliance rates and subject retention rates. For the purposes of analysis, acceptability was assessed through a 1-on-1 semi-structured interview, consisting of an 11-item flash glucose monitoring system satisfaction scale and 4 open-ended questions on sensor-related preferences.

Overall, 136 subjects were referred to the study. Of these, 33.3% could not be contacted, 17.6% were undecided, 25.0% declined due to lack of interest or time, and 23.5% agreed to participate in the study. The cohort of 32 subjects included in the study had a mean age of 52 years and a mean duration of prediabetes of 1.5 years. When asked to rate the importance of reversing prediabetes on a scale of 0 to 10, with 10 indicating very important, the average score was 9.7.

Over the 28-day period, all subjects adhered to using the first followed by the second sensor. A total of 16 sensors fell off and required replacement, with an overall average number of days of sensor wear among participants of 25 days.

Regarding the open questions, the researchers noted a couple of themes that came up when questioning the “best” of using a sensor, which were “positive behavior change” and “better understanding from real-time feedback.” When evaluating the “worst” of using a sensor, “sensor mechanics” was the only issue identified by the researchers.

The highlights of the 11-item satisfaction scale are listed below:

62.5% disagreed or disagreed that wearing the sensors caused others to ask too many questions about their health status. 75% disagreed or disagreed that wearing the sensor was uncomfortable or painful. 81.3% agreed or strongly agreed that the sensor reminded them to stay healthy every day. .68.8% agreed or strongly agreed that they would pay a copay to use a flash glucose monitoring system sensor for people with prediabetes if covered by insurance. 78.1% agreed or strongly agreed that they would want to use the device when the research study was finished, if possible.

“Future studies should incorporate larger randomized controlled studies to better assess the advantages and disadvantages of incorporating [flash glucose monitoring system] sensors in the care of people with prediabetes”, added the researchers.

This study, “Feasibility and Acceptability of Using Flash Glucose Monitoring System Sensors to Enhance Lifestyle Changes in People with Prediabetes,” was published in Diabetes Care.