What are the quality of life-related benefits and losses associated with real-time continuous glucose monitoring? A survey of current users.

BACKGROUND: How does real-time (RT) continuous glucose monitoring (CGM) affect quality of life (QOL)? We explored the types and frequencies of diabetes-specific QOL changes resulting from RT-CGM as reported by current users and investigated what patient-reported factors predict these changes.

SUBJECTS AND METHODS: Current RT-CGM users (n = 877) completed an online questionnaire investigating perceived QOL benefits/losses since RT-CGM initiation and RT-CGM attitudes and behavior. Exploratory factor analysis (EFA) examined the 16 QOL benefit/loss items to identify underlying factors. Regression analyses examined associations between demographics and RT-CGM attitudes and behavior with the QOL factors emerging from the EFA.

RESULTS: Three major QOL factors emerged: Perceived Control over Diabetes, Hypoglycemic Safety, and Interpersonal Support. QOL improvement was common for Perceived Control over Diabetes and Hypoglycemic Safety (86% and 85% of respondents, respectively), although less common for Interpersonal Support (37%). Consistent independent predictors of perceived benefits were greater confidence in using RT-CGM data (P<0.001), satisfaction with device accuracy (P ≤ 0.05) and usability (P<0.01), older age (P<0.01), more frequent receiver screen views (P<0.05), and use of multiple daily injections (Hypoglycemic Safety and Interpersonal Support, P ≤ 0.05).

CONCLUSIONS: Diabetes-specific QOL benefits resulting from RT-CGM were common. Major predictors of QOL benefits were satisfaction with device accuracy and usability and trust in one's ability to use RT-CGM data, suggesting that "perceived efficacy," for both device and self, are key QOL determinants. Psychoeducational strategies to boost confidence in using RT-CGM data and provide reasonable device expectations might enhance QOL benefits.