Abstract
Continuous glucose monitors (CGMs) have the potential to improve glycemic outcomes, but adolescents are the least likely group to wear these devices. The purpose of this study was to explore reasons why adolescents may stop using their CGM (termed CGM "breaks"). 21 adolescents with type 1 diabetes (T1D) participated in semi-structured qualitative interviews. Interviews explored reasons for CGM breaks and the impacts of these breaks on psychosocial factors and diabetes management. CGM breaks were categorized as forced or voluntary. Forced breaks typically occurred due to problems with insurance coverage, inter-institutional communication, and supply shortages. Adolescents reported taking voluntary CGM breaks because they needed a mental break from CGM, and because of skin/adhesive issues. Adolescents described several consequences of these breaks, including changes in diabetes management and effects on automated insulin delivery systems, loss of autonomy, and changes in mood. CGMs and automated insulin delivery systems are now recommended for most people with T1D; however, many adolescents with T1D do not consistently use CGMs. Our findings regarding adolescents' reasons for taking breaks from CGMs highlight the need for providers to share information on how diabetes - and specifically pump - management may change when off CGMs. Systems-level solutions to limit forced CGM breaks are key to limiting time off CGMs.
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