Continuous glucose monitoring as an educational strategy

Abstract

Continuous glucose monitoring (CGM) has proven to be an effective educational strategy for both people with type 1 and type 2 diabetes, and even today there is evidence for supporting education on behavior change in prediabetes and people without diabetes. Several studies have shown that CGM not only helps control blood glucose but also facilitates real-time learning, allowing people to visualize how decisions affect blood glucose, learning the impact in real time. This promotes behavior change by strengthening self-regulation and commitment to treatment.

It is an interesting reinforcement of structured education because it encourages active learning, as patients interpret their own data, generating motivational feedback and a basis for communication with the physician through data analysis to identify patterns. It is a dynamic teaching tool. Several studies show benefits for HbA1c, self-confidence, and treatment adherence.

Alfadhli et al. (2016) conducted a study in women with gestational diabetes using real-time CGM and specifically defined it as an "educational tool." They concluded that CGM facilitates understanding of the relationship between eating patterns and blood glucose levels, improving control during pregnancy.

Rivera Ávila et al. (2021) evaluated CGM as an educational tool and supplement to standard care, finding a significant reduction in HbA1c in the group that used CGM with educational support compared to the control group (−0.61).

In Korea, a nutritional education program combined with flash glucose monitoring or capillary blood glucose monitoring was evaluated. Participants in the flash monitoring group had greater reductions in fasting glucose (−16.5 mg/dL; p=0.017), body weight (−1.5 kg; p=0.013), HbA1c (−0.50%; p<0.001), and a better self-management questionnaire score at postintervention. Martens et al. demonstrated that patients with T2DM who used CGM in conjunction with appropriate education achieved significant improvements in glycemic control. Similarly, Welsh et al. found that sustained use of CGM, coupled with ongoing education, resulted in significant and sustained improvements in glycemic control and a reduction in hypoglycemia in adults with T1DM.

Personalized education and ongoing support are essential to overcome barriers to technology adoption. Initial assessments allow educational programs to be tailored to individual needs, while ongoing support, through follow-up sessions and support groups, helps maintain motivation and adherence.

In short, CGM is a powerful educational tool, providing valuable information for self-monitoring and informed decision-making in diabetes management.