Published in PLOS One on 2026-07-16, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Lorrein Muhwava, Elena Marbán-Castro, Mpho Silima, Maria Karsas, Tanja Kemp, Johane Freitas, Yvonne Kamau, Beatrice Vetter, Cathy Haldane, Paul Rheeder, Michelle Carrihill, Joel A Dave, Sonjelle Shilton
Source: PLOS One • DOI 10.1371/journal.pone.0352590
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Continuous Glucose Monitoring (CGM) is an advancement in diabetes management, offering real-time insights into blood glucose levels and facilitating decision-making around diabetes care. However, its adoption in low- and middle-income countries (LMICs) remains low. This study explored the perceptions and experiences of CGM use among people living with type 1 diabetes (T1D), their caregivers, and healthcare providers (HCPs) in the public sector in South Africa.
Convenience sampling was used to recruit participants from the ACCEDE study – a pragmatic randomised controlled trial on CGM use among people living with T1D in South Africa. Between July 2024 and February 2025, we conducted focus group discussions (FGDs) with recipients of care and caregivers and semi-structured interviews (SSIs) with HCPs across study sites in Cape Town and Pretoria. All FGDs and SSIs were audio-recorded, transcribed, and analysed using MAXQDA 2022. Data analysis followed thematic content analysis, and the findings presented according to the socioecological framework.
A total of 107 participants, including 75 people living with T1D, 17 caregivers, and 15 HCPs, were included in the study. CGM was generally perceived as acceptable due to convenience, reduced need for finger-prick testing, and enhanced understanding of glucose patterns. Feasibility was enhanced by ease of use, access to training, and social support. Key barriers included cost, limited awareness, and socio-economic constraints such as food insecurity and lack of access to transport.
CGMs are both feasible and acceptable within South Africa’s public healthcare context. However, integration requires a coordinated, multi-level response, strengthening provider and patient awareness, knowledge, adequately resourced multi-disciplinary diabetes care teams, and addressing affordability through supportive health policies.
Introduction
Continuous Glucose Monitoring (CGM) is a significant advancement in diabetes management, offering real-time insights into blood glucose levels and facilitating informed decision-making around diabetes care [1,2]. CGMs reduce the burden of frequent finger-prick testing and support personalised diabetes management through data-driven decision-making [3]. Studies have reported that CGM use is also associated with improved diabetes-related quality of life, including reduced anxiety related to glucose fluctuations, fewer finger-prick tests, and increased confidence in self-management, as well as a reduced frequency and duration of hypoglycaemic episodes, particularly for individuals on insulin therapy [4,5]. As a result, CGM technology has been widely integrated into standard diabetes care in many high-income countries, particularly for individuals with type 1 diabetes (T1D) and those on intensive insulin therapy [6,7]. In countries such as the United States, the United Kingdom, and Germany, CGMs are routinely used in clinical practice and often reimbursed by national health systems or insurance providers [8]. Their integration has contributed to improved glycaemic outcomes, including reductions in HbA1c, increased time-in-range, and fewer diabetes-related events, and has become a key component of personalised diabetes management in these settings [5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Lorrein Muhwava, Elena Marbán-Castro, Mpho Silima, Maria Karsas, Tanja Kemp, Johane Freitas, Yvonne Kamau, Beatrice Vetter, Cathy Haldane, Paul Rheeder, Michelle Carrihill, Joel A Dave, Sonjelle Shilton. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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