preprint · medRxiv
A qualitative study conducted at a tertiary referral hospital in Nairobi, Kenya, evaluated the acceptability and user experiences of continuous glucose monitoring devices among people with type 1 diabetes, caregivers, and healthcare providers. Participants, including adolescents, young adults, caregivers, and clinicians, were assessed after using continuous glucose monitors for at least seven weeks. Overall, participants reported high acceptability and increased engagement with glucose monitoring. Key benefits included the reduction of painful finger-prick tests, discreet real-time alerts, and simplified data sharing between patients and clinicians. Caregivers noted a reduced daily monitoring burden, whilst healthcare providers highlighted improved clinical decision-making supported by detailed glycaemic insights. Despite these benefits, high device costs and limited availability were identified as substantial obstacles to sustained adoption. Addressing these economic and logistical barriers remains essential for wider implementation in resource-constrained environments.
Managing type 1 diabetes in low- and middle-income countries is frequently hindered by limited access to routine testing and consistent clinical care. By demonstrating that continuous glucose monitoring is highly acceptable and clinically helpful to patients, families, and doctors in an urban African setting, this work highlights the practical value of modern monitoring tools while pinpointing critical economic barriers that prevent broader healthcare adoption.
This work demonstrates applied user-testing of existing continuous glucose monitoring technology within a resource-constrained healthcare setting. It highlights clear demand among patients, caregivers, and clinicians for real-time diabetes tracking tools. However, commercial uptake remains distant without business models that tackle high unit costs and supply chain constraints. Medical device manufacturers and digital health companies must deliver affordable devices, local distribution channels, and data-sharing interfaces adapted to low- and middle-income markets.
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Abstract Background Type 1 diabetes (T1D) is a growing public health concern in low-and middle-income countries, where access to glucose monitoring and consistent routine care remains limited. Continuous glucose monitoring (CGM) may improve diabetes outcomes, but evidence of its acceptability and use in low-resource settings is limited. This study explored the perceptions and experiences of CGM use among people living with T1D, their caregivers, and healthcare providers (HCPs). Methods Participants were recruited from the ACCEDE-U study, a usability study on CGM use among people living with T1D attending a tertiary referral hospital in Nairobi, Kenya. Among 40 participants in the ACCEDE-U study, those who had completed at least seven weeks of CGM use were eligible to participate in the qualitative component. Three focus group discussions (FGDs) were conducted: one with nine caregivers, one with nine adolescents (12-17 years), and one with six young adults (18-24 years). Semi-structured interviews were conducted with 9 HCPs. Data was collected using guides, audio-recorded, transcribed, and analyzed thematically guided by the socioecological framework. CORE-Q guidelines were used to report results. Results Participants reported increased engagement in glucose monitoring and high acceptability of CGM. Reduced finger-prick testing and real-time alerts were key benefits, particularly among adolescents and young adults, who valued its discreetness and convenience. CGM was perceived to facilitate sharing of glucose data with HCPs. Caregivers reported a reduced monitoring burden. HCPs perceived CGM as valuable for clinical decision-making by providing real-time insights into glycemic patterns. Cost and limited device availability were identified as major barriers to sustained use. Conclusion CGM was well accepted and perceived as beneficial. However, challenges related to cost and access may limit broader uptake. Improving affordability and availability could enhance feasibility and promote wider implementation in similar settings.
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DOI: 10.64898/2026.08.16.26359665
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