'You have to use everything and come to some equilibrium': a qualitative study on hypoglycemia self-management in users of continuous glucose monitor with diverse hypoglycemia experiences.
BMJ Open Diabetes Res Care
; 11(3)2023 06.
Article
in En
| MEDLINE
| ID: mdl-37349107
ABSTRACT
INTRODUCTION:
Although continuous glucose monitoring systems (CGMs) can help reduce hypoglycemia, about one-quarter of people with type 1 diabetes (T1D) who use CGMs still either spend at least 1% of the time with dangerously low blood glucose or develop severe hypoglycemia. This study explored experiences around hypoglycemia self-management in people who are living with T1D and using CGMs to identify factors contributing to hypoglycemia development. RESEARCH DESIGN ANDMETHODS:
Purposive sampling and semistructured interviews with 28 respondents with T1D and using CGMs were conducted to explore experiences around hypoglycemic episodes and hypoglycemia self-management during CGM use. Open coding and thematic analysis were employed to identify emergent themes related to hypoglycemia experiences.RESULTS:
About one-third of respondents each respectively spent 0%, 0.1%-0.9% and ≥1% of time in level 2 hypoglycemia; 39% had impaired awareness of hypoglycemia and 32% had severe hypoglycemia in the past 6 months. Four themes were generated (1) prioritizing symptoms over CGM data (subthemes hypoglycemia symptoms for confirming hypoglycemia and prompting management actions; minimal management actions without hypoglycemia symptoms); (2) distraction from the demands of daily life; (3) concerns about hypoglycemia management choices (subthemes fear of rebound hyperglycemia; other health consequences related to sugary food consumption; aversions to treatment foods and treatment food consumption); and (4) social influences on management choices (subthemes positively perceived social support and inclusion; unwanted attention to oneself or concerns about inconveniencing others; social stigma and criticism related to hypoglycemia and CGM use).CONCLUSIONS:
Despite using CGMs, people with T1D can face a complex biopsychosocial process of managing hypoglycemia. Interventions for addressing psychosocial and behavioral barriers are needed to improve hypoglycemia self-management in those who continue to face challenges in minimizing hypoglycemia while using CGMs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Diabetes Mellitus, Type 1
/
Self-Management
/
Hypoglycemia
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Qualitative_research
Limits:
Humans
Language:
En
Journal:
BMJ Open Diabetes Res Care
Year:
2023
Document type:
Article
Affiliation country:
Estados Unidos