A study of 1,503 adults with type 1 diabetes measured barriers to device uptake (insulin pump and continuous blood glucose monitors (CGM)) and compared the proﬁles of device users versus nonusers. For the whole sample, from a list of 19, the three most commonly endorsed barriers to diabetes device uptake were ‘cost of supplies’ (61%), ‘cost of device’ (57%) and ‘insurance coverage’ (57%), all of which were deemed to be ‘non-modifiable’ barriers by the authors. The top three commonly endorsed ‘modifiable’ barriers were ‘hassle of wearing devices all of the time’ (47%), ‘do not like having diabetes devices on my body’ (35%) and ‘do not like how diabetes devices look on my body’ (26%).
Among those who had previously used a diabetes device (CGM and/or insulin pump), the most common reasons for discontinuation of CGM (n=249) were ‘cost of supplies’ (35%), ‘too many alarms’ (32%), ‘it was not accurate’ (30%), and ‘do not like having diabetes devices on my body’ (30%) and the most common reasons for discontinuing an insulin pump (n=72) were ‘do not like having diabetes devices on my body’ (46%), ‘it was uncomfortable or painful’ (44%) ‘cost of supplies’ (21%) and ‘did not trust it’ (21%).
The youngest age-group (18–25 years) had the lowest CGM and insulin pump uptake, highest diabetes distress, and highest HbA1c levels, thus the authors concluded that this age group should be the focus of future interventions to increase device use. They also concluded that interventions should also focus on reducing physical barriers to wearing devices, as these were among the most highly endorsed ‘modifiable’ barriers.
Tanenbaum ML, Hanes SJ, Miller KM, Naranjo D, Bensen R, Hood KK. Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets. Diabetes Care, 2017; 40:181–187.