Impact of Early Versus Publicly Funded Adoption of Flash Glucose Monitoring on Metabolic Outcomes and Self-Care in Type 1 Diabetes.

Background

Flash glucose monitoring (FGM) technology has transitioned from private acquisition to universal public subsidization.

Objective

This study examined changes in metabolic outcomes and self-care behaviors associated with the timing of FGM adoption.

Methods

An observational, pre-post study was conducted with 206 adults with type 1 diabetes (representing 91.2% of the local health area population). Participants were categorized into "early adopters" (prior private use) and "post-funding adopters" (initiation after public subsidy). Clinical data and Self-Care Inventory-Revised (SCI-R) scores were analyzed over a 1-year follow-up period.

Results

After 1 year, both cohorts demonstrated significant improvements in glycosylated hemoglobin (HbA1c) and basal glycemia. Early adopters maintained superior glycemic profiles compared with the post-funding group (HbA1c: 6.86 ± 0.77 vs. 7.77 ± 1.24; p < .001). Post-funding adopters showed statistically significant pre-post changes in lipid profile and creatinine levels. While global SCI-R scores improved for all participants, scores for exercise and preventive behaviors remained suboptimal and showed no significant change.

Conclusions

Early adoption of FGM is associated with sustained metabolic advantages. However, the persistence of low scores in exercise and prevention, regardless of technology use, underscores the critical need for targeted nurse-led interventions in primary care to address lifestyle-based self-management gaps. Implications for Nursing: The study shows that flash glucose monitoring (FGM) is associated with improved metabolic control and self-care adherence in people with type 1 diabetes. These findings may contribute to improving clinical practice, particularly nursing care and diabetes management. They may also support greater access and funding for glucose monitoring technologies. Further research is needed to address exercise promotion and self-care education in this population.