Patient Experience with Continuous Glucose Monitoring During Dialysis in Type 2 Diabetes: A Qualitative Study

Objective: To explore the lived experiences of type 2 diabetes mellitus (T2DM) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD) using continuous glucose monitoring (CGM). Research Design and Methods: A qualitative phenomenological study was conducted with 50 adult T2DM patients on PD or HD who used CGM for at least 14 days. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis framework was applied to identify major themes regarding insulin management, CGM utilization, and emotional and social dimensions. Results: Four main themes emerged, each with multiple subthemes. PD patients emphasized enhanced autonomy and frequent insulin adjustments due to dialysate glucose absorption. Conversely, HD patients reported severe post-dialysis fatigue, emotional distress, and limited social engagement often associated with intra-dialytic hypoglycemia. CGM was valued by 85% of participants for improving metabolic awareness and self-management. However, 15% reported barriers such as device cost and technical difficulties. The insights clearly distinguish the differential impact of dialysis modality on daily glucose control and patient well-being. Conclusions: These findings underscore the critical need for patient-centered care incorporating access to CGM and tailored insulin regimens. Equitable implementation of CGM in dialysis settings could significantly enhance glycemic control, emotional resilience, and overall quality of life.