Identification of Continuous Glucose Monitoring Self-Management Structured Education Programs for People with Type 1 Diabetes Mellitus: A Mixed Methodology Systematic Review.

BACKGROUND

The use and innovation of continuous glucose monitoring systems (CGMs) offer a wealth of information regarding glycemic variability on a day-to-day basis, providing the opportunity to assess the broader picture of glycemic control compared with the static data from Blood Glucose Monitors. Diabetes self-management structured education (DSMSE) is the cornerstone of successful diabetes management. Educational programs on CGMs self-management, structured following National Institute for Health and Care Excellence (NICE) guidelines, have shown remarkable outcomes in glycemic management, technology acceptance and adherence, user satisfaction, and the reduction of diabetes-related distress.

PURPOSE: Our study aims to gather information on all available structured educational programs for CGM self-management in people with type one diabetes and analyze their characteristics.

METHODS

The study is a mixed-method systematic review (PROSPERO registration number CRD42024579331). We searched the following databases (Cochrane Library, CINAHL, PubMed, and PsycINFO) from inception to May 7, 2024.

RESULTS

We included nine studies documenting nine structured educational programs on CGM self-management. These studies, published between 2019 and 2023, targeted adults, adolescents, and pediatric populations with type one diabetes using real-time CGM (rt-CGM) or intermittent scanning CGM (isCGM). Overall, 7/9 programs (ie, the CGM Academy, both versions, Spectrum, Flash, IDEAL, Share-plus, and ABC/is-CGM) met all the criteria for structured educational programs.

CONCLUSION

Taking into consideration any limitation due to study heterogeneity, programs such as Spectrum and CGM Academy serve as comprehensive models, for CGM self-management education, as they meet all the NICE UK structured education criteria, and offer the most robust, holistic, and evidence-based curricula. They incorporate the most effective approaches, methods, and materials based on literature and utilize rt-CGM technology, which broader clinical evidence suggests is superior to isCGM in improving Time in Range and reducing hypoglycemia. The CGM Academy is particularly suited for pediatric and young adult populations, whereas Spectrum targets all populations (pediatric and adult) regardless of the rt-CGM manufacturer.