While CGM devices have been around for decades, their use has been restricted due to low accuracy, high cost, and bulky devices. CGM systems work by giving individuals the means to know their blood glucose levels as part of diabetes self-management without controlling blood glucose directly. They can be categorised into blinded systems (also called professional CGM, where glucose readings are not immediately visible to the wearer), unblinded systems, and flash glucose monitors (also called intermittently scanned CGM or isCGM see, for example, Wood et al., 2018). The burden on the individual is also reduced considerably.ĬGM systems continue to be developed by a number of different manufacturers (see Lin et al. 96–298 readings/day), which would be impossible with SMBG. CGM systems provide a more comprehensive assessment of glycaemia by measuring glucose levels every 5–15 min (i.e. In recent years, continuous glucose monitoring (CGM), measuring glucose in interstitial tissue, has become increasingly used in diabetes care, particularly for individuals with type 1 or insulin-controlled type 2 diabetes. Furthermore, data are not collected continuously during a 24-h period, for example overnight or while the individual is working, driving, or otherwise occupied, leading to glucose levels throughout large parts of the day not being captured. ![]() SMBG places the onus on the user, is often perceived as burdensome, and compliance can be low. Self-monitoring of blood glucose (SMBG) throughout the day using finger-prick tests has been used as an adjunct to regular HbA1c checks to support glycaemic control. As any given HbA1c measurement might correspond to a range of mean glucose levels, HbA1c may, for some patients, fail to reliably indicate how well their glucose is controlled. However, due to the nature of HbA1c, this measurement does not detect hypoglycaemia and fluctuations in glucose levels, both of which are implicated in adverse clinical outcome. Traditionally, glycaemic control has been assessed using glycated haemoglobin (HbA1c) as a proxy measure of average blood glucose over the 8- to 12-week period prior to measurement. Inadequately controlled glucose levels can lead to serious microvascular and macrovascular complications, creating significant strain on the health system and impairing quality of life. Systematic review registrationįor individuals living with diabetes, glucose control is an important part of self- and clinical management. This review will provide new knowledge with the potential to inform a programme theory of CGM as well as future roll-out to potentially vulnerable populations, including those with severe mental illness. Ongoing assessment of the acceptability of interventions has been identified as crucially important to scale-up and implementation. The most appropriate method for integrating qualitative and quantitative findings will be selected based on the data available. ![]() Where possible, quantitative evidence will be combined using random-effects meta-analysis otherwise, a narrative synthesis will be performed. Qualitative evidence will be analysed using framework analysis informed by the Theoretical Framework of Acceptability. Quantitative data relating to acceptability and feasibility including data loss, adherence, and quantitative ratings of acceptability will be extracted as means and standard deviations or n/N as appropriate. Data extraction will include key information about each study, as well as qualitative evidence in the form of participant quotes from primary studies and themes and subthemes based on the authors’ analysis. Study selection and data extraction will be carried out by two reviewers independently using Rayyan and Eppi-Reviewer, respectively, with disagreements resolved by discussion. We will not restrict the search by language. Searches will be restricted to studies conducted in humans and those published from 2011 onwards. We will not apply any study-type filters. We will search MEDLINE, Embase, CINAHL, and CENTRAL for qualitative and quantitative evidence about the feasibility and acceptability of CGM in all populations with diabetes (any type) using search terms for “continuous glucose monitoring” and “diabetes”. This is a protocol for a mixed-methods systematic review of qualitative and quantitative evidence about acceptability and feasibility of CGM in people with diabetes. However, there is no current comprehensive evidence on the acceptability and feasibility of these devices. Availability of this technology is increasing worldwide. ![]() Continuous glucose monitoring (CGM) offers a non-invasive and more detailed alternative. ![]() Traditional assessment methods, including HbA1c checks and self-monitoring of blood glucose, can be unreliable and inaccurate. Good glycaemic control is a crucial part of diabetes management.
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