Perception of adult patients with uncontrolled DM type 2 on disease burden, control and on continuous glucose monitoring

BACKGROUND: Control of diabetes remains a significant global health problem. The availability of continuous glucose monitoring (CGM) device has significantly impacted its management; whether it would be a useful tool to engage patients with uncontrolled diabetes mellitus (DM) type 2 in their care, is unclear. Gaining insight on disease perception of this group would be helpful.

AIM: This qualitative study obtained perceptions of patients with uncontrolled DM type 2, on disease burden, disease control and experience with using CGM.

METHOD/PARTICIPANTS: A 21-item survey questionnaire was mailed to 489 adult patients ages 18-75 with DM type 2 empaneled to 3 primary care clinics, who had hemoglobin A1c of =/>8% and who gave research authorization. Questionnaire has 6 sections: About diabetes, home glucose testing, medications, self-management, Problem Areas in Diabetes (PAID-5), and continuous glucose monitoring.

RESULTS: Sixteen percent (n=79) completed the survey. Majority (59%) were diagnosed with DM >10 years ago; most reported problems were vision impairment and peripheral neuropathy. When asked on scale of 1-5 (1=poorly controlled, 5=very well controlled), how well controlled diabetes is, 63% (n=50) responded 3-4; only 8 responded 1-2 “poorly controlled”. Regarding self-management, 84% stated completely managing diabetes on their own; only 27% reported needing help with medication management, diet, and glucose monitoring. Diabetes distress was evaluated using PAID-5 (Problem Areas in Diabetes); over 50% of responders did not feel that diabetes was taking too much of their physical and mental energy. However, 49% worried about the future and possibility of serious complications. While 65/79 responders have heard of CGM, only 16 have used it. Over 90% expressed interest in knowing more about CGM and using it. Perceived benefits included: ability to monitor effect of diet and exercise, better tracking of readings and ease in checking glucose.

CONCLUSIONS: Adult patients with uncontrolled DM 2 expressed high interest in CGM and had perceived benefits to its use. Despite having uncontrolled DM, majority perceived their disease to be in good control, reported low level of diabetes distress, and high degree of self-management. Findings provided insight on factors that hinder treatment engagement and have potential implication on practice-based interventions addressing diabetes control in this population group.