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Kathryn Kreider Part 7, Can A CGM Help With Diabetes Distress?

In part 7, the conclusion of this Exclusive Interview, Kathryn Kreider talks with Diabetes in Control Publisher Steve Freed about the use of technology to help patients experiencing diabetes distress.

Kathryn Kreider is an Assistant Professor at Duke University School of Nursing in Durham, NC.


Transcript of this video segment:

Freed: Sometimes with technology, we see new things that can change the way we treat patients. For example, the CGM is fairly new. Do you see that as, because it’s providing more information — if you normally check three times a day, now you get readings every three minutes, and people relate to that in different ways- – so, do you find that technology has increased distress or decreased it?

Kreider: That is very patient dependent in my experience, because some patients feel more empowered when they have more information and some feel more overwhelmed. And so, I think the patient really has to understand the implications of the technology and what it can ultimately do for them, but we have to balance individuality with that, knowing that that might not be the best option for every patient, especially if they’re very anxious. And so, sort of thinking about them holistically in deciding whether or not that’s the best approach is really important.

Freed: And that’s interesting because I just spoke to a physician who refers patients, type 2. He uses a blinded CGM at first, so that it doesn’t overwhelm the patient. And then he switches them to the un-blinded CGM. What are your thoughts about using that type of concept for a type 2 patient or even a type 1?

Kreider: Sure. I think it’s interesting. I haven’t heard of that outside of a research study before, but I think it could be an interesting approach so that people can warm up to it. A lot of them are not used to wearing a device all of the time, so that’s very new concept. So, getting used to actually wearing it before you start seeing the data and the implications could be very valuable. I think that’s really interesting.

Freed: I think if you used an un-blinded device on a type 2 who checks their blood sugar once a week and all of a sudden they have all these readings for having the type of food and activity and emotional situation that they’re in, that to me would be overwhelming and causing distress in itself.

Kreider: Yes, and I think that that point about technology impact has shown up certainly in the type 1 literature related to diabetes distress, because they are more likely to use technology at this point. And it can cause a great deal of distress, because it’s actually more difficult to wear a pump than it is to give injections and things like that. So, we really have to consider that as providers, what the impact of that would be.

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