Feasibility and acceptability of the use of flash glucose monitoring encountered by Indigenous Australians with type 2 diabetes mellitus: initial experiences from a pilot study

Audrey Sing Yi Eer; Rebecca Chia Yee Ho; Tracey Hearn; Mariam Hachem; Megan Freund; Luke James Burchill; Sharon Atkinson-Briggs; Satpal Singh; Sandra Eades; Richard Charles O'Brien; John Stuart Furler; David Norman O'Neal; David Andrew Story; Jeffrey David Zajac; Sabine Braat; Alex Brown; Phillip Clarke; Ashim Kumar Sinha; Anna Gerardina McLean; Stephen Morris Twigg; Elif Ilhan Ekinci

doi:10.1186/s12913-023-10121-6

Feasibility and acceptability of the use of flash glucose monitoring encountered by Indigenous Australians with type 2 diabetes mellitus: initial experiences from a pilot study

BMC Health Serv Res. 2023 Dec 8;23(1):1377. doi: 10.1186/s12913-023-10121-6.

Authors

Audrey Sing Yi Eer^{1

2}, Rebecca Chia Yee Ho³, Tracey Hearn^{4

5}, Mariam Hachem^{2

6

7}, Megan Freund^{8

9}, Luke James Burchill^{10

11}, Sharon Atkinson-Briggs^{5

12}, Satpal Singh⁵, Sandra Eades^{13

14}, Richard Charles O'Brien^{15

16

17}, John Stuart Furler¹⁸, David Norman O'Neal^{7

19

20}, David Andrew Story^{1

21

22}, Jeffrey David Zajac^{2

23}, Sabine Braat^{14

24}, Alex Brown²⁵, Phillip Clarke^{7

26

27}, Ashim Kumar Sinha^{28

29}, Anna Gerardina McLean^{30

31}, Stephen Morris Twigg^{7

32

33}, Elif Ilhan Ekinci^{34

35

36}

Affiliations

¹ Austin Health, Heidelberg, VIC, Australia.
² The University of Melbourne (Austin Health), Melbourne, VIC, Australia.
³ Albany Health Campus, Spencer Park, WA, Australia.
⁴ The University of Melbourne, Melbourne, VIC, Australia.
⁵ Rumbalara Aboriginal Co-Operative, Mooroopna, VIC, Australia.
⁶ Centre for Research and Education in Diabetes and Obesity (CREDO), Faculty of Dentistry Health Sciences and Medicine, The University of Melbourne, Austin Health, Melbourne, Australia.
⁷ The Australian Centre for Accelerating Diabetes Innovation (ACADI), The University of Melbourne, Parkville, Australia.
⁸ Research Academic, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
⁹ Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
¹⁰ Royal Melbourne Hospital, Parkville, VIC, Australia.
¹¹ Department of Medicine (Royal Melbourne Hospital), Aboriginal Cardiovascular Health Equity Research Group, The University of Melbourne, Melbourne, VIC, Australia.
¹² Department of Medicine, The University of Melbourne, Melbourne, Australia.
¹³ Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
¹⁴ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
¹⁵ Austin Clinical School, The University of Melbourne, Melbourne, VIC, Australia.
¹⁶ Graduate Programs and Executive Education, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
¹⁷ Lipid Services, Austin Health, Heidelberg, VIC, Australia.
¹⁸ Department of General Practice, Faculty of Medicine Dentisty and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
¹⁹ St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
²⁰ The University of Melbourne (St. Vincent's Hospital), Melbourne, VIC, Australia.
²¹ Department of Critical Care, The University of Melbourne, Melbourne, Australia.
²² Melbourne Academic Centre for Health (MACH), Melbourne, VIC, Australia.
²³ Division of Medicine, Medical Services CSU and Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia.
²⁴ MISCH (Methods and Implementation Support for Clinical Health) research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
²⁵ Indigenous Genomics, Australian National University and Telethon Kids Institute, Canberra, Australian Capital Territory, Australia.
²⁶ Health Economics, Nuffield Department of Public Health, Univeristy of Oxford, Oxford, UK.
²⁷ Academic, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
²⁸ Diabetes and Endocrinology, Cairns Hospital, Cairns, QLD, Australia.
²⁹ James Cook University, Cairns, QLD, Australia.
³⁰ Endocrinology and General Medicine, Cairns Hospital, Cairns, QLD, Australia.
³¹ Menzies School of Health Research, Darwin, NT, Australia.
³² Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
³³ Endocrinology, Stan Clark Chair in Diabetes, Faculty in Diabetes, The University of Sydney, Sydney, NSW, Australia.
³⁴ Austin Health, Heidelberg, VIC, Australia. [email protected].
³⁵ The Australian Centre for Accelerating Diabetes Innovation (ACADI), The University of Melbourne, Parkville, Australia. [email protected].
³⁶ Sir Edward Weary Dunlop Principal Research Fellow in Metabolic Medicine, University of Melbourne, Melbourne, VIC, Australia. [email protected].

Abstract

Background: Type 2 diabetes mellitus (T2DM) is highly prevalent within the Indigenous Australian community. Novel glucose monitoring technology offers an accurate approach to glycaemic management, providing real-time information on glucose levels and trends. The acceptability and feasibilility of this technology in Indigenous Australians with T2DM has not been investigated.

Objective: This feasibility phenomenological study aims to understand the experiences of Indigenous Australians with T2DM using flash glucose monitoring (FGM).

Methods: Indigenous Australians with T2DM receiving injectable therapy (n = 8) who used FGM (Abbott Freestyle Libre) for 6-months, as part of a clinical trial, participated in semi-structured interviews. Thematic analysis of the interviews was performed using NVivo12 Plus qualitative data analysis software (QSR International).

Results: Six major themes emerged: 1) FGM was highly acceptable to the individual; 2) FGM's convenience was its biggest benefit; 3) data from FGM was a tool to modify lifestyle choices; 4) FGM needed to be complemented with health professional support; 5) FGM can be a tool to engage communities in diabetes management; and 6) cost of the device is a barrier to future use.

Conclusions: Indigenous Australians with T2DM had positive experiences with FGM. This study highlights future steps to ensure likelihood of FGM is acceptable and effective within the wider Indigenous Australian community.

Keywords: Aboriginal people; Flash glucose monitoring; Indigenous Australian; Phenomenological study; Qualitative research; Type 2 diabetes mellitus.

MeSH terms

Australia
Australian Aboriginal and Torres Strait Islander Peoples
Blood Glucose / analysis
Blood Glucose Self-Monitoring* / methods
Diabetes Mellitus, Type 2* / therapy
Feasibility Studies
Humans
Pilot Projects

Substances

Blood Glucose