P-267: Barriers to self-glucose monitoring in Kenyan youth with type 1 diabetes
K Maureen, C Lagat, E Omondi, J Kimeto, J Njunguru, G GathechaAbstract
Introduction
Self-glucose monitoring remains standard in low- and middle-income countries, yet its effectiveness depends on a consistent supply of functional equipment. In sub-Saharan Africa, where glycemic control remains poor, barriers to SGM are still unquantified. This limits advocacy for continuous glucose monitoring.
Objectives
To describe SGM practices, equipment barriers, and monitoring gaps among Kenyan youth with T1D To identify implications for CGM introduction.
Methods
Cross-sectional survey of 3,847 participants aged <25 years across 46 CDiC clinics in 35 Kenyan counties. Questionnaires assessed glucometer ownership, functionality, test strip supply, testing frequency, reasons for missed monitoring, and blood glucose knowledge.
Results
Glucometer ownership (75.4%) and awareness (89.0%) were high, but effective monitoring was undermined by supply gaps and equipment failure. Participants received mean 1.34 test strip boxes monthly (median 1), and 10.4% of owned devices were non-functional. Testing frequency was suboptimal: 21.8% tested ≤1 time daily. Missed monitoring was driven by damaged equipment (45.0%), insulin shortage (17.0%), and pain from pricking (12.0%). Only 33.8% fully understood blood glucose concepts, and confirmatory testing during symptoms was inconsistent (68.4% when high, 71.2% when low), indicating reactive rather than proactive self-management.
Conclusions
SGM in Kenya is compromised by inadequate test strip supply, equipment failure, and low metabolic literacy, and not lack of clinical access. These structural barriers provide strong rationale for piloting CGM, which could eliminate supply-chain dependence, reduce pain-related non-adherence, and enable proactive glucose management in a population with 92.7% poor glycemic control.