Intermittently Scanned and Continuous Glucose Monitor Systems: A Systematic Review on Psychological Outcomes in Pediatric Patients
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Published on: February 24, 2023
Roberto Franceschi1, Francesca Micheli1, Enza Mozzillo2
1Pediatric Unit, S. Chiara Hospital, Trento, Italy.
Insights
Intermittently scanned continuous glucose monitoring (isCGM) may improve psychological well-being in adolescents with diabetes, while real-time CGM (rtCGM) offers benefits in patient and parent satisfaction. Both technologies impact quality of life differently.
Area of Science:
- Pediatric Endocrinology
- Diabetes Technology
- Psychological Health
Background:
- Continuous glucose monitoring (CGM) is increasingly used in pediatric diabetes management.
- Understanding the psychological impact of different CGM types (rtCGM vs. isCGM) is crucial for optimizing care.
- Evidence on the psychological outcomes for children and caregivers using CGM needs systematic evaluation.
Conclusions:
- isCGM may offer greater psychological benefits, particularly for adolescents, while rtCGM excels in patient and parent satisfaction.
- The choice between rtCGM and isCGM should consider both metabolic control goals and psychological well-being.
- Further high-quality RCTs are needed to definitively assess the psychological impact of CGM technologies.
Abstract:
Aim: To explore the impact of real-time continuous glucose monitoring (rtCGMs) or intermittently scanned/viewed CGM (isCGM) on psychological outcomes in children and caregivers, and to grade the level of evidence. Method: Systematic review of the literature from PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Nursing reference center, Up to date, Google Scholar, and PsycINFO databases. The studies selected used validated questionnaires for investigating the psychological outcomes. We applied GRADE (Grading of Recommendations Assessment, Development and Evaluation) to rank the quality of a body of evidence. Results: A total of 192 studies were identified in the initial search and after the process of evaluation 25 studies were selected as appropriate to be included in this systematic review. We found in moderate quality studies that isCGM in adolescents can improve diabetes related distress, family conflicts, fear of hypoglycemia, and quality of life, while depression, anxiety, and quality of sleep have not yet been evaluated by validated questionnaires. In moderate-high quality studies, rtCGM technology does not impact on diabetes burden, diabetes specific family conflict, and depressive symptoms. The effect on fear of hypoglycemia, sleep quality, and anxiety is still debated and RCT studies powered to find significant results in psychological outcomes are lacking. RtCGM increases satisfaction and quality of life in parents and patients wearing rtCGM. Conclusion: these data present an interesting point to consider when families are deciding whether or not to start CGM use, choosing between rtCGM to reach a tighter metabolic control, or isCGM which allows greater benefits on psychological outcomes.
