Overview
Aim 1: Characterize shared decision-making and unmet patient-caregiver dyads needs for patients with diabetes and Alzheimer's Disease and related dementias (ADRD) while using a continuous glucose monitoring (CGM) device.
Aim 2: Develop an interactive tool to enhance shared decision-making for diabetes management.
Description
Aim 1: Patient-caregiver dyads will participant in a semi-structured interview to establish a baseline. The dyad will receive standard diabetes educational materials along with a CGM training and instructions for device use. Patients will then wear the CGM device for 14 days. Three follow-up interviews will take place during the 14-day scanning period, as well as a debrief interview following the scanning period for assessment and technical support.
Aim 2: Patient-caregiver dyads and clinicians will participate in a user-centered design session to guide the design of interactive information displays to improve the interpretability of CGM data.
Eligibility
Patient-Caregiver Dyad Inclusion Criteria (Aims 1 + 2):
- patient must have dual diagnosis of MCI or ADRD and diabetes (DM)
- patient must have active prescriptions for DM
- patient must have had at least one visit to an Eskenazi or IU Health primary care clinic within 12 months
- patient must be able to provide assent and have a legally authorized representative (LAR) consent on their behalf if patient lacks capacity to consent
- patient must have a caregiver aged 18 years or older who interacts daily, or almost daily, with the patient
- patient and caregiver must both speak English
- patient and caregiver must both reside in the community
- dyad must have internet access
Patient-Caregiver Dyad Exclusion Criteria (Aims 1 +2):
- patient has terminal illness
- use of an automated insulin delivery system
- patient is receiving dialysis
- patient is taking ascorbic acid during monitoring period
- patient has existing implanted medical devices
- patient has a bleeding disorder
- patient has a pre-existing arm skin lesions
- patient has an allergy to medical adhesive or isopropyl alcohol
- patient has plans for imaging or diathermy treatment during the study period
Clinician Participant Inclusion Criteria (Aim 2):
- primary care physicians
- nurses
- pharmacists
- nutritionists
- psychologists
- medical residents
Clinician Participant Exclusion Criteria (Aim 2):
- only treats patients younger than 65 years
- does not manage patients' DM