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Psychosocial barriers hinder success of CGM
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ADA 70th Scientific Sessions
It may be useful to review psychosocial barriers, such as difficulties coping with frustrations, to determine whether a patient with type 1 diabetes will be successful with continuous glucose monitoring, Marilyn Ritholz, PhD, said here.
Ritholtz and her team at the Joslin Diabetes Center studied the psychosocial barriers that may impede patients’ successful use of a continuous glucose monitoring (CGM) system and found that those who used problem-solving skills for coping with frustrations; who saw CGM as a mechanism for better understanding glucose patterns; and who had good support from a spouse or significant other were more likely to achieve good results with using this technology.
However, patients who described emotional responses to frustrations, who failed to synthesize data from CGM and who lacked emotional support were less likely to benefit from CGM use. Body image concerns did not differentiate those who used CGM successfully from those who did not, but were discussed by both groups as a possible barrier in CGM use.
“We were interested in the human experience of CGM and, so far, studies have not shown which factors predict or are associated with successful or unsuccessful use of CGM,” Ritholtz, senior psychologist at Joslin Diabetes Center and assistant professor of psychology at Harvard Medical School, said at a press conference.
Ritholtz presented the data at the Joint American Diabetes Association/Juvenile Diabetes Research Foundation Symposium.
William Tamborlane, MD, chief of pediatric endocrinology at Yale University, discussed previously published data that linked the difficulties in using current evidence on a daily basis to the failure of CGM to lower HbA1c levels in children and adolescents. The study evaluated adults aged 25 years and older, as well as children, teens and young adults aged 8 to 24 years.
“There was a sense that CGM was just too hard to get to work right, and to get benefit from these devices you actually need to use them,” Tamborlane said.
Dr. Ritholtz had a fascinating presentation to tell us that patient experience is equally important to the technology. Patient learning, adapting and thinking problems through is critical, and I agree that we need both. Technology, well-trained patients and a better understanding of how they accept the technology are all integral to CGM.
– Richard Bergenstal, MD
Executive
Director of the International Diabetes Center,
American Diabetes
Association President, Medicine and Science
For more information:
- Ritholtz W. Joint ADA/JDRF Symposium. Should new diabetes drugs submitted to the FDA have a higher bar for cardiovascular safety than other drugs? Presented at: The American Diabetes Association 70th Scientific Sessions; June 25-29, 2010; Orlando.
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