Abstract
Few studies have examined the impact of newer CGM systems on QOL. 2400 insulin-using adults (> 18 y) who were current Dexcom CGM users with > 6 months CGM experience were invited to complete an online questionnaire examining their perception of benefits and losses since CGM initiation, current CGM use, and physician involvement. After 11 days, 877 completed surveys were received and the survey site was closed. Participants: type 1 DM (93%); mean age (42 years); 46% male; 72% used CSII; 65% college graduates; and 90% non-Hispanic White.
78% reported CGM use > 22 days/month; 64% checked the receiver screen > twice/hour; and 94% reported at least moderate confidence in using the CGM data. 59% noted their physician downloaded and reviewed their CGM data at most or every visit.
79% of respondents reported CGM had helped (moderately or a great deal) improve their QOL. 16 items examined specific benefits and losses. For each, participants indicated whether things were now much worse, slightly worse, no change, slightly better, or much better due to CGM use. Factor analysis detected 3 subscales: perceived control over DM (PCOD, 7 items), hypoglycemia safety (HS, 5 items), and interpersonal support (IS, 3 items). Mean scores pointed to broad positive improvement in PCOD (86% of patients), HS (84%), and, to a lesser degree, in IS (37%); consistent worsening in any of the three subscales was rare (< 5%).
Multiple regression analysis revealed the most consistent independent predictors of perceived benefits across the 3 subscales were more frequent CGM use (all β’s > .12, P < .001) and greater confidence in using CGM data (all β’s > .18, P < .001). Pump use, more frequent receiver screen views, and more frequent physician data review were not linked in any consistent manner to greater perceived benefits. These data suggest that current Dexcom CGM users perceive substantial QOL benefits from use of the device; benefits are more apparent in those who use the device more frequently and those who are confident in using the data.
