Kyle is a 55-year-old man with type 2 diabetes for ten years. He was recently diagnosed with retinopathy in both eyes. His grandmother lost her eyesight due to diabetes. Due to this family history, he is very concerned about his new diagnosis. He uses a Libre continuous glucose monitor (CGM) to monitor his blood sugar levels. During your visit, he is preoccupied with checking his Libre CGM and tells you that he uses his glucometer to verify CGM readings at least four to six times per day. When you ask him about this, he reports that he can’t focus on his work or home life if he isn’t over 90% time in range.
As a diabetes care and education specialist, what is the best approach to this situation?
- Reassure Kyle that retinopathy is very common with type 2 diabetes. Encourage him to verify the CGM with his glucometer more frequently if that helps make him feel less anxious.
- Educate Kyle that the CGM he is using cannot be calibrated and instruct him to stop using his glucometer, since the CGM is accurate.
- Acknowledge Kyle’s fears about vision loss, screen for diabetes distress, and collaborate on strategies to reduce the emotional burden of CGM use, including referral to a behavioral health provider if indicated.
- Adjust Kyle’s time in range target goal to >90% to meet his expectations and reduce his worry about complications.
