Patients’ interpretation of Ambulatory Glucose Profile (AGP), CGM, and pump reports [abstract]
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Aim: Determine how patients review CGM and insulin pump data simultaneously to determine self-treatment adjustments. Methods: Subjects (n=21) verbally reported their interpretation/thoughts while examining an AGP (CGM + Insulin Pump) Report in a cognitive interview. Interviews lasted 45-90 minutes. Results: Subjects overwhelmingly prefer phone/watch interfaces; 75% do not have computers at home. Users report looking at their phones/CGM readings on average 16-60 times a day (1-4 times/hour); with several reporting high frequency of 15-45 times/hour. All subjects prefer colored graphs rather than numerical data on a single page report, with heavy preference to focus on CGM data with only occasional review of insulin pump data. Subjects felt the AGP CGM + Pump Report was “helpful” (86%), yet only 57% felt it was easy to understand due to the basal vs. bolus graphs. When asked to identify glucose data patterns: 95% noted trends, 67% noted hypoglycemia, 95% noted hyperglycemia, and 100% identified “missed” opportunities to treat high daily glucose levels. Bolus insulin graph responses included: bolus dose times of day helpful (100%), average meal bolus helpful (71%), and 73% understood the graph after an explanation, but only 38% could teach back offering specific advice. Subjects felt basal insulin graph made sense (90%). Subject confidence using AGP report data for self-care was high (95%) and would allow independent decision making about their DM care including identifying treatment next steps and determining how insulin dosing affects glucose trends. Seventy percent would feel confident making changes to their care by themselves using this report including adjustment of their pump settings, while 90% felt it would help with basal rate adjustments. Conclusion: CGM metrics and pattern visualization have recently been standardized in an AGP CGM report. Our patient interview reinforces that the same efforts are needed worldwide to standardize CGM and insulin dose (pump and connected pen) reporting.