Understanding the Emotional, Social, and Existential Dimensions of Living with Continuous Glucose Monitoring: An Interpretative Phenomenological Analysis of Adults with Type 2 Diabetes
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Abstract
Digital health technologies have significantly transformed chronic disease management by enabling real-time monitoring and personalized care. Among these innovations, Continuous Glucose Monitoring (CGM) devices play a central role in supporting self-management for individuals with type 2 diabetes, yet the subjective experiences associated with CGM use remain underexplored. While prior research has examined clinical outcomes and user satisfaction, it has not adequately addressed how individuals experience CGM emotionally, socially, and existentially in their everyday lives. This study investigates the following question: How do adults with type 2 diabetes experience and make meaning of using CGM devices in their daily lives, beyond clinical parameters and usability metrics? Using an interpretative phenomenological approach, this study provides insights into the lived experiences of CGM users, with a focus on how the device influences their sense of self, emotional well-being, and social interactions in daily routines. Semi-structured interviews were conducted with nine adult CGM users (aged 38–66 years), each with at least six months of device usage, and data were analyzed using Interpretative Phenomenological Analysis (IPA). The findings revealed five key themes: a sense of reassuring surveillance, intrusions into daily and social life, emotional oscillations between safety and dependence, stigma as the visible mark of illness, and navigating hope through technological trust. These themes illustrate that CGM use is not simply a biomedical intervention, but a deeply embedded experience that shapes identity, autonomy, and interpersonal dynamics. In contrast to previous studies that primarily emphasize clinical outcomes or usability, this study foregrounds the nuanced psychosocial and existential dimensions of CGM usage. It contributes to a more human-centered understanding of health technology and highlights the importance of integrating patient experiences into device design and policy development. These findings offer a foundation for future research exploring technological embodiment in chronic care contexts.
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References
Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., Bosi, E., Buckingham, B. A., Cefalu, W. T., Close, K. L., Cobelli, C., Dassau, E., Hans DeVries, J., Donaghue, K. C., Dovc, K., Doyle, F. J., Garg, S., Grunberger, G., Heller, S., … Phillip, M. (2019). Clinical targets for continuous glucose monitoring data interpretation: Recommendations from the international consensus on time in range. Diabetes Care, 42(8), 1593–1603. Scopus. https://doi.org/10.2337/dci19-0028
Beck, R. W., Connor, C. G., Mullen, D. M., Wesley, D. M., & Bergenstal, R. M. (2017). The fallacy of average: How using hba1c alone to assess glycemic control can be misleading. Diabetes Care, 40(8), 994–999. Scopus. https://doi.org/10.2337/dc17-0636
Beck, R. W., Riddlesworth, T. D., Ruedy, K., Ahmann, A., Haller, S., Kruger, D., McGill, J. B., Polonsky, W., Price, D., Aronoff, S., Aronson, R., Toschi, E., Kollman, C., & Bergenstal, R. (2017). Continuous glucose monitoring versus usual care in patients with type 2 diabetes receiving multiple daily insulin injections. Annals of Internal Medicine, 167(6), 365–374. Scopus. https://doi.org/10.7326/M16-2855
Brown, S. A., Kovatchev, B. P., Raghinaru, D., Lum, J. W., Buckingham, B. A., Kudva, Y. C., Laffel, L. M., Levy, C. J., Pinsker, J. E., Wadwa, R. P., Dassau, E., Doyle, F. J., Anderson, S. M., Church, M. M., Dadlani, V., Ekhlaspour, L., Forlenza, G. P., Isganaitis, E., Lam, D. W., … Beck, R. W. (2019). Six-month randomized, multicenter trial of closed-loop control in type 1 diabetes. New England Journal of Medicine, 381(18), 1707–1717. Scopus. https://doi.org/10.1056/NEJMoa1907863
Danne, T., Nimri, R., Battelino, T., Bergenstal, R. M., Close, K. L., DeVries, J. H., Garg, S., Heinemann, L., Hirsch, I., Amiel, S. A., Beck, R., Bosi, E., Buckingham, B., Cobelli, C., Dassau, E., Doyle, F. J., Heller, S., Hovorka, R., Jia, W., … Phillip, M. (2017). International consensus on use of continuous glucose monitoring. Diabetes Care, 40(12), 1631–1640. Scopus. https://doi.org/10.2337/dc17-1600
Feig, D. S., Donovan, L. E., Corcoy, R., Murphy, K. E., Amiel, S. A., Hunt, K. F., Asztalos, E., Barrett, J. F. R., Sanchez, J. J., de Leiva, A., Hod, M., Jovanovic, L., Keely, E., McManus, R., Hutton, E. K., Meek, C. L., Stewart, Z. A., Wysocki, T., O’Brien, R., … Pragnell, M. (2017). Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): A multicentre international randomised controlled trial. The Lancet, 390(10110), 2347–2359. Scopus. https://doi.org/10.1016/S0140-6736(17)32400-5
Garg, S. K., Weinzimer, S. A., Tamborlane, W. V., Buckingham, B. A., Bode, B. W., Bailey, T. S., Brazg, R. L., Ilany, J., Slover, R. H., Anderson, S. M., Bergenstal, R. M., Grosman, B., Roy, A., Cordero, T. L., Shin, J., Lee, S. W., & Kaufman, F. R. (2017). Glucose Outcomes with the In-Home Use of a Hybrid Closed-Loop Insulin Delivery System in Adolescents and Adults with Type 1 Diabetes. Diabetes Technology and Therapeutics, 19(3), 155–163. Scopus. https://doi.org/10.1089/dia.2016.0421
Heinemann, L., Freckmann, G., Ehrmann, D., Faber-Heinemann, G., Guerra, S., Waldenmaier, D., & Hermanns, N. (2018). Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): A multicentre, randomised controlled trial. The Lancet, 391(10128), 1367–1377. Scopus. https://doi.org/10.1016/S0140-6736(18)30297-6
Kim, J., Sempionatto, J. R., Imani, S., Hartel, M. C., Barfidokht, A., Tang, G., Campbell, A. S., Mercier, P. P., & Wang, J. (2018). Simultaneous Monitoring of Sweat and Interstitial Fluid Using a Single Wearable Biosensor Platform. Advanced Science, 5(10). Scopus. https://doi.org/10.1002/advs.201800880
Li, P. K.-T., Chow, K. M., Cho, Y., Fan, S., Figueiredo, A. E., Harris, T., Kanjanabuch, T., Kim, Y.-L., Madero, M., Malyszko, J., Mehrotra, R., Okpechi, I. G., Perl, J., Piraino, B., Runnegar, N., Teitelbaum, I., Wong, J. K.-W., Yu, X., & Johnson, D. W. (2022). ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Peritoneal Dialysis International, 42(2), 110–153. Scopus. https://doi.org/10.1177/08968608221080586
Lind, M., Polonsky, W., Hirsch, I. B., Heise, T., Bolinder, J., Dahlqvist, S., Schwarz, E., Ólafsdóttir, A. F., Frid, A., Wedel, H., Ahlén, E., Nyström, T., & Hellman, J. (2017). Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections the gold randomized clinical trial. JAMA - Journal of the American Medical Association, 317(4), 379–387. Scopus. https://doi.org/10.1001/jama.2016.19976
Lu, J., Ma, X., Zhou, J., Zhang, L., Mo, Y., Ying, L., Lu, W., Zhu, W., Bao, Y., Vigersky, R. A., & Jia, W. (2018). Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care, 41(11), 2370–2376. Scopus. https://doi.org/10.2337/dc18-1131
Miller, K. M., Foster, N. C., Beck, R. W., Bergensta, R. M., DuBose, S. N., DiMeglio, L. A., Maahs, D. M., & Tamborlane, W. V. (2015). Current state of type 1 diabetes treatment in the U.S.: Updated data from the t1d exchange clinic registry. Diabetes Care, 38(6), 971–978. Scopus. https://doi.org/10.2337/dc15-0078
Sempionatto, J. R., Lin, M., Yin, L., De la paz, E., Pei, K., Sonsa-ard, T., de Loyola Silva, A. N., Khorshed, A. A., Zhang, F., Tostado, N., Xu, S., & Wang, J. (2021). An epidermal patch for the simultaneous monitoring of haemodynamic and metabolic biomarkers. Nature Biomedical Engineering, 5(7), 737–748. Scopus. https://doi.org/10.1038/s41551-021-00685-1
Tehrani, F., Teymourian, H., Wuerstle, B., Kavner, J., Patel, R., Furmidge, A., Aghavali, R., Hosseini-Toudeshki, H., Brown, C., Zhang, F., Mahato, K., Li, Z., Barfidokht, A., Yin, L., Warren, P., Huang, N., Patel, Z., Mercier, P. P., & Wang, J. (2022). An integrated wearable microneedle array for the continuous monitoring of multiple biomarkers in interstitial fluid. Nature Biomedical Engineering, 6(11), 1214–1224. Scopus. https://doi.org/10.1038/s41551-022-00887-1
Weisman, A., Bai, J.-W., Cardinez, M., Kramer, C. K., & Perkins, B. A. (2017). Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: A systematic review and meta-analysis of outpatient randomised controlled trials. The Lancet Diabetes and Endocrinology, 5(7), 501–512. Scopus. https://doi.org/10.1016/S2213-8587(17)30167-5
Yin, R. K. (2011). Qualitative research from start to finish. Guilford Press.