A Study of Letters Written to Glucose Monitors by Individuals Living with Type 1 Diabetes and with Experience of Disordered Eating.

In recent years, diabetes technologies have advanced significantly, as such, flash and continuous glucose monitors (FGM/CGM) are more widely accessible. To date, little research has explored the specific benefits or pitfalls that FGM/CGM use may come with for individuals with type 1 diabetes and disordered eating (T1DE). Therefore, this study aimed to explore the relationship that those living with type 1 diabetes and experience of disordered eating have with their FGM/CGM. This qualitative study asked participants to write letters addressed to their FGM/CGM. These letters were analysed using reflexive thematic analysis (RTA) to explore individuals with T1DE relationship to the device. Four themes were constructed: ‘I Don’t Always Like or Want You...I NEED You... but I Wish I Didn't’, ‘Facing the Facts’, ‘You are Intertwined with Disordered Eating’, ‘You Communicate with Others’. Each theme comprises subthemes. The themes demonstrate how participants appeared to have a dichotomous and nuanced relationship to their FGM/CGM, identifying both positive and negative aspects of their relationship to the device. There appears to be an interplay between the FGM/CGM and disordered eating which may be specific to individuals with T1DE. Implications including recommendations for integrated diabetes and disordered eating care and development to psychological care are discussed.