Proper training and follow-up for patients new to continuous glucose monitor (CGM) use is required to maintain adherence and improve outcomes. However, CGM training is hampered by a lack of evidence-based standards and poor reimbursement. The aim of this pilot feasibility study was to test a theory-driven, web-based intervention designed to provide extended training and follow-up support to patients newly implementing CGM, and to describe CGM adherence, glycemic control and psychosocial measures pre- and post-intervention.
Participants were new to CGM, 15-24 years old, with type 1 diabetes for >6 months. Each was randomized to enhanced standard care alone or in addition to the “Intervention Designed to Educate and improve Adherence through Learning to use CGM”, (IDEAL CGM) web-based training intervention using a 3:1 randomization scheme. Outcome measures were collected pre- and post- 3-month study period.
In total, eight participants were randomized. Within the IDEAL CGM group 4/6 participants received exposure to the web-based training. This study demonstrated proof of concept and indicated components of the intervention may be effective despite insufficient evidence to determine the feasibility of the IDEAL CGM intervention and its described impact on diabetes-related outcomes.
This research underscores the importance of continued efforts to 1) establish evidence-based standards for training patients using CGM, 2) determine the dosage and/or level of educational exposure associated with improved outcomes and 3) determine key design elements of the web-based intervention to increase engagement, dissuade attrition, and ensure attainment of the skills necessary to achieve consistent use and improvements in glycemic control.