ArticleFrontiers in clinical diabetes and healthcare2026
Acceptability of blinded continuous glucose monitoring for people with serious mental illness and type 2 diabetes: findings from an exploratory mixed-methods study.
Article in Frontiers in clinical diabetes and healthcare, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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