DOI: 10.4103/ijdt.ijdt_31_26 ISSN: 2949-8457

Assessment of Continuous Glucose Monitoring Knowledge in a Type 1 Diabetes Population: An Empower T1D Pre-/Posteducational Intervention Study

Manisha Gupta, Amit Kumar Dey, Rutul Goklani, Riddhi Modi, Hitesh Saraogi
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Abstract

Background:

Continuous glucose monitoring (CGM) improves glycemic outcomes in type 1 diabetes (T1D), but its effectiveness depends on the user’s ability to interpret CGM data and translate it into safe therapeutic decisions. In India, CGM uptake is rising, yet structured assessment of CGM literacy among experienced users is lacking.

Aim:

The aim of this study was to evaluate CGM-related knowledge before and after a structured educational session in an experienced T1D cohort and to identify priority learning domains for future training programs.

Methods:

A pre-/posttest, single-arm, quasi-experimental study was conducted by the Empower T1D community in December 2025. Ninety-five participants with T1D (94.7% prior CGM users – 78.9% FreeStyle Libre, 15.8% Dexcom class) attended bilingual (Hindi/English) educational sessions delivered by three diabetologists. A 10-item Likert scale (1–5) questionnaire covering core CGM domains was administered before and after the session via Google Forms. Statistical analysis included descriptive statistics, Cronbach’s α reliability, one-way analysis of variance, and Pearson’s correlation analysis to map inter-item knowledge structure.

Results:

Baseline knowledge was high (premean: 4.66 ± 0.82) with a pronounced ceiling effect that constrained detectable change (postmean: 4.58 ± 0.76). Cronbach’s α improved from 0.20 to 0.67, indicating maturation of a coherent knowledge construct. Three correlation-defined domains emerged: Technology Foundation (Q1 ↔ Q10, r = 0.95 pre), Practical Use (Q2 ↔ Q4, r = 0.70 pre), and Metrics Integration (Q3 ↔ Q5, r = 0.81 post – newly emergent). Self-rated competence declined for advanced metrics (time above range [TAR]/time below range [TBR]: −6.6% and ambulatory glucose profile [AGP] interpretation: −6.1%) and accuracy/compression awareness (post 4.33 ± 1.11), while practical operational items (sensor-site selection, calibration, and troubleshooting) improved. Although the overall mean self-rated score showed a small numerical decline (4.66–4.58) after the session, the postsession response pattern suggested greater differentiation of advanced knowledge domains and highlighted specific areas requiring reinforced training rather than uniform immediate gain across all topics. These findings should therefore be interpreted as exploratory evidence of unmet educational needs and possible recalibration of self-perceived competence, rather than definitive proof of short-term knowledge improvement or clinical benefit.

Conclusion:

Experienced Indian T1D users excel at CGM operation but require targeted training in advanced metric interpretation and accuracy/safety limitations. The postsession emergence of a time-in-range mastery cluster validates the higher-order impact of structured education. The CGM curricula in India should be tiered by user experience, expand AGP- and TAR/TBR-specific content, and reinforce confirmatory self-monitoring during compression artifacts and rapid glycemic excursions.

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