Acceptability of blinded continuous glucose monitoring for people with serious mental illness and type 2 diabetes: findings from an exploratory mixed-methods study.
5 affiliations
- 1School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
- 2Department of Health Sciences, University of York, York, United Kingdom.
- 3Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
- 4Hull York Medical School, University of York, York, United Kingdom & Bradford District Care NHS Foundation Trust, Saltaire, United Kingdom.
- 5School of Nursing and Public Health, Manchester Metropolitan University, Manchester, United Kingdom.
Abstract
Introduction
People with serious mental illness (SMI) experience a disproportionately high prevalence of type 2 diabetes and a reduced life expectancy of 15 to 20 years. While continuous glucose monitoring (CGM) has revolutionised diabetes self-management in the general population, its feasibility and acceptability among individuals living with co-existing SMI remain largely unexamined.Methods
The study was embedded within the DIAMONDS feasibility study. Community-dwelling adults with SMI and type 2 diabetes (N = 21 eligible) were invited to wear a blinded CGM sensor (FreeStyle LibrePro) for 14 days. Quantitative metrics evaluated uptake, wear duration, data completeness, and adverse events. Semi-structured qualitative interviews (n = 9) explored user experiences. The qualitative analysis used a hybrid human-AI framework approach to map findings onto the Theoretical Framework of Acceptability (TFA) and the Theoretical Domains Framework (TDF), followed by data integration using a convergence coding matrix.Results
Sixteen participants agreed to wear the device (76.2% uptake), achieving a mean wear duration of 11 days. Of the returned sensors with data, 92.8% captured ≥5 days of readings, and no adverse events were reported. Qualitative analysis demonstrated highly positive affective attitudes and a significantly lower perceived burden compared with traditional finger-stick testing, despite minor challenges with sensor adhesion. Cross-framework integration revealed that high acceptability was driven by the device's low-friction physical layout, positive participant beliefs about data consequences, and alignment with a proactive, research-contributing identity.Discussion
The use of blinded CGM is both feasible and acceptable for people living with SMI and type 2 diabetes. These findings offer a robust foundation for developing structured, low-burden, and theory-informed physical health interventions aimed at closing the mortality gap in this underserved population.
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BibTeX
@article{brown2026acceptability,
title = {{Acceptability of blinded continuous glucose monitoring for people with serious mental illness and type 2 diabetes: findings from an exploratory mixed-methods study.}},
author = {Jennifer V E Brown and Ramzi A Ajjan and Najma Siddiqi and Peter A Coventry},
journal = {Frontiers in clinical diabetes and healthcare},
year = {2026},
month = oct,
doi = {10.3389/fcdhc.2026.1923186},
url = {https://europepmc.org/article/MED/42909332},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acceptability of blinded continuous glucose monitoring for people with serious mental illness and type 2 diabetes: findings from an exploratory mixed-methods study.
AU - Jennifer V E Brown
AU - Ramzi A Ajjan
AU - Najma Siddiqi
AU - Peter A Coventry
PY - 2026
DA - 2026/10/07
JO - Frontiers in clinical diabetes and healthcare
DO - 10.3389/fcdhc.2026.1923186
UR - https://europepmc.org/article/MED/42909332
AB - Introduction People with serious mental illness (SMI) experience a disproportionately high prevalence of type 2 diabetes and a reduced life expectancy of 15 to 20 years. While continuous glucose monitoring (CGM) has revolutionised diabetes self-management in the general population, its feasibility and acceptability among individuals living with co-existing SMI remain largely unexamined.Methods The study was embedded within the DIAMONDS feasibility study. Community-dwelling adults with SMI and type 2 diabetes (N = 21 eligible) were invited to wear a blinded CGM sensor (FreeStyle LibrePro) for 14 days. Quantitative metrics evaluated uptake, wear duration, data completeness, and adverse events. Semi-structured qualitative interviews (n = 9) explored user experiences. The qualitative analysis used a hybrid human-AI framework approach to map findings onto the Theoretical Framework of Acceptability (TFA) and the Theoretical Domains Framework (TDF), followed by data integration using a convergence coding matrix.Results Sixteen participants agreed to wear the device (76.2% uptake), achieving a mean wear duration of 11 days. Of the returned sensors with data, 92.8% captured ≥5 days of readings, and no adverse events were reported. Qualitative analysis demonstrated highly positive affective attitudes and a significantly lower perceived burden compared with traditional finger-stick testing, despite minor challenges with sensor adhesion. Cross-framework integration revealed that high acceptability was driven by the device's low-friction physical layout, positive participant beliefs about data consequences, and alignment with a proactive, research-contributing identity.Discussion The use of blinded CGM is both feasible and acceptable for people living with SMI and type 2 diabetes. These findings offer a robust foundation for developing structured, low-burden, and theory-informed physical health interventions aimed at closing the mortality gap in this underserved population.
SN - 2673-6616
ER -