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Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use
Open accessAbstract
BACKGROUND: Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room for improvement, and consistent adherence is needed to achieve better outcomes. Diabetes health care providers have important roles to play in promoting device use and adherence. METHODS: We surveyed 209 clinicians who treat people with type 1 diabetes to examine perceptions of barriers to device uptake, attitudes toward diabetes technology, and resources needed for clinicians to improve device uptake. We compared findings with our survey of adults with T1D. RESULTS: Younger clinicians treated more patients using insulin pumps ( r = -.26, P < .001) and CGM ( r = -.14, P = .02), and had more positive attitudes about diabetes technology ( r = -.23, P = .001). The most frequently endorsed modifiable barriers were perceptions that patients dislike having the device on their body (73% pump; 63% CGM), dislike the alarms (61% CGM), and do not understand what to do with device information or features (40% pump; 46% CGM). Clinicians wanted lower cost and better insurance coverage for their patients, and they recommended counseling and education to help address barriers and improve adherence to devices. CONCLUSION: Clinicians perceive many barriers to their patients initiating and adhering to diabetes devices. Findings highlight opportunities for intervention to improve clinician-patient communication around device barriers to help address them.
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“For people with insulin-requiring diabetes, dosing instructions may be complex and confusing (3-6).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“While recent guidelines call for continuous glucose monitoring (CGM) use for all who require insulin, regardless of diabetes type (7), there is also evidence that patients may not know how to interpret what to do with the CGM data (6, 8, 9).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]
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In the citing paper
“As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [6]
Experimental — accuracy not yet measured
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Citations
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Metadata
- Authors
- Tanenbaum, M. L., Adams, R. N., Hanes, S. J., Barley, R. C., Miller, K. M., Mulvaney, S. A., & Hood, K. K.
- Affiliations
- Stanford Medicine (US)
- Jaeb Center for Health Research (US)
- Vanderbilt University (US)
- Corresponding author
- Hood, Korey K.
- ORCID
- Venue
- Journal of Diabetes Science and Technology
- Publisher
- SAGE Publications
- Published
- 2017-01-10
- Volume
- 11
- Issue
- 3
- Pages
- 484-492
- ISSN
- 1932-2968 (ISSN-L)
- PMC
- PMC5505431
- OpenAlex
- W2572387108
- Cited by
- 117
- References
- 30
- Citations by year
- 2026: 12 · 2025: 8 · 2024: 21 · 2023: 15 · 2022: 14 · 2021: 16 · 2020: 15 · 2019: 9 · 2018: 7
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Diabetes Science and Technology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Leona M. and Harry B. Helmsley Charitable Trust
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- type 1 diabetes, insulin pump, continuous glucose monitors, diabetes technology adoption, device adherence, clinician attitudes, clinician-patient communication, patient education, insurance coverage, device cost
- MeSH terms
- Adult, Diabetes Mellitus, Type 1, Female, Humans, Insulin Infusion Systems, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Monitoring, Physiologic, Patient Compliance, Practice Patterns, Physicians', Surveys and Questionnaires
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