The impact of flash glucose monitoring on adults with type 1 Diabetes’ eating habits and relationship with food

• Published in: Diabetes research and clinical practice Vol. 196; p. 110230
• Main Authors: Wallace, T., Heath, J., Koebbel, C.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2023
• Subjects: Adult; Blood Glucose; Blood Glucose Self-Monitoring; Diabetes Mellitus, Type 1; Disordered eating; Eating behavior; Feeding Behavior; Flash glucose monitoring; Humans; Qualitative research; Relationship with food; Type 1 diabetes; Qualitative research; Flash glucose monitoring; Type 1 diabetes; Disordered eating; Eating behavior; Relationship with food
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2022.110230

•FSL use influences diet, including what, when, why and how much users eat.•Participants using FSL described increased self-efficacy to handle complex foods.•For some, the FSL reinforced the notion of food as a mathematical problem.•At times, users sought permission from the data to eat and ignored hunger urges.•Participants noted their relationship with diabetes shifted following FSL use. To gain a better understanding of how the FreeStyle Libre (FSL) flash glucose monitor influences the eating habits and relationship with food of adults with type 1 diabetes (T1D). Reflexive thematic analysis was conducted on fifteen semi-structured interviews conducted with adults with T1D, exploring their experiences of at least one year of FSL use. Four themes were constructed from the qualitative data: (1) Personal Food Story (what food represented before and after diabetes diagnosis), (2) New Opportunities (the FSL offered novel discoveries and increased self-confidence regarding food choices), (3) Body as a Machine (participants viewed their bodies as a collection of complex processes requiring continuous maintenance), and (4) re-evaluating Diabetes (participants expressed a shift in their expectations of themselves and their diabetes management). Although the FSL offered participants more freedom and flexibility with their eating, this was constrained by feeling forever under scrutiny from the data. Findings suggest the FSL influences users’ eating habits, including when, why, what and how much they eat. Participants described both the positive and negative impact of these changes on their emotional wellbeing and relationship with diabetes, arguing for a need to address patients’ relationship with food in routine clinic care.