Acceptability and usability of continuous glucose monitoring systems in older adults aged 75 years and older with diabetes

Purpose: The purpose of this study is to explore the acceptability and usability of continuous glucose monitoring (CGM) systems as experienced by older adults aged 75 years and older with diabetes. Methods: Using a qualitative research design, data were collected through semi-structured interviews with 14 older adults aged 75 years and older with diabetes who had no prior experience with CGM, following two weeks of CGM use. Transcripts were analyzed using a thematic qualitative analysis method to identify key statements related to participants’ experiences with CGM, with a focus on acceptability and usability. Results: CGM was generally perceived as acceptable and useful by participants. Four key themes emerged from the analysis: Device-related burdens, barriers to CGM use, duality of CGM impact, and reflection and empowerment, along with 9 sub-themes. While CGM significantly enhanced glucose management awareness and promoted healthier lifestyle changes, it also induced psychological stress due to constant monitoring. Participants noted several barriers such as the inconvenience of carrying and charging a mobile device, complex device operations, and difficulties using educational materials due to visual impairments. The high cost of the CGM device was seen as a substantial economic barrier, underscoring the necessity for financial interventions like broader insurance coverage for individuals with type 2 diabetes. Conclusion: This study suggests that CGM may improve health outcomes for older adults aged 75 years and older with diabetes by enhancing both its acceptability and usability. It highlights the need for comprehensive technical, educational, and financial support to facilitate effective CGM usage in older adults aged 75 years and older with diabetes. Recommendations to improve usage include the adoption of wearable devices or dedicated receivers, extended battery life, user-friendly interfaces with larger fonts and clearer visual presentations, and enhanced insurance coverage.