Patton Susana R, Clements Mark A
University of Kansas Medical Center, Kansas City, KS, USA Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA
Children's Mercy-Kansas City, Kansas City, MO, USA University of Missouri-Kansas City, Kansas City, MO, USA.
J Diabetes Sci Technol. 2016 May 3;10(3):656-61. doi: 10.1177/1932296816638109. Print 2016 May.
Glucose monitoring is prerequisite to all other diabetes self-care behaviors and helps patients to reduce their risk for diabetes-related complications due to elevated glycemia. Because of the amount of information available and the ability to deliver glucose results in real-time, continuous glucose monitoring (CGM) has the ability to improve on self-monitoring blood glucose. However, epidemiologic data demonstrate slow uptake of CGM by patients, especially among youth. Several new diabetes therapies rely on CGM for feedback on patients' glucose levels to optimize treatment (eg, the low-glucose suspend insulin pump) and there are new technologies currently in development that will also need this information to work (eg, the artificial pancreas). To help patients to realize the potential benefits of these new treatments, it is essential to explore patients' psychological and behavioral reactions to CGM and then target device enhancements and/or the development of behavioral therapies to minimize negative reactions and to improve patients' CGM adoption rates. Limited research is available examining the psychological and behavioral reactions of CGM use in youth exclusively, but there are more studies examining these reactions in mixed samples of youth, parents, and adults. The purpose of this review is to summarize the available literature examining psychological and behavioral reactions to CGM use in young people with diabetes and to highlight how the results of past and future studies can inform device updates and/or behavioral intervention development to minimize barriers.
血糖监测是所有其他糖尿病自我护理行为的前提条件,有助于患者降低因血糖升高而引发糖尿病相关并发症的风险。由于可获取的信息量以及实时提供血糖结果的能力,连续血糖监测(CGM)能够改进自我血糖监测。然而,流行病学数据显示患者对CGM的接受程度较低,尤其是在青少年中。几种新的糖尿病治疗方法依赖CGM来获取患者血糖水平的反馈以优化治疗(例如,低血糖暂停胰岛素泵),并且目前正在研发的新技术也需要这些信息来发挥作用(例如,人工胰腺)。为了帮助患者认识到这些新治疗方法的潜在益处,探索患者对CGM的心理和行为反应,然后针对性地改进设备和/或开发行为疗法,以尽量减少负面反应并提高患者对CGM的接受率至关重要。专门研究青少年使用CGM的心理和行为反应的研究有限,但有更多研究在青少年、父母和成年人的混合样本中考察这些反应。本综述的目的是总结现有文献中关于糖尿病青少年使用CGM的心理和行为反应,并强调过去和未来研究的结果如何为设备更新和/或行为干预开发提供信息,以减少障碍。