Currently submitted to: JMIR Diabetes
Date Submitted: Apr 21, 2026
Open Peer Review Period: Apr 24, 2026 - Jun 19, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
“He said it was being pierced all over his body. He was tired. He didn't want it anymore”: Care giver perceptions of blood glucose monitoring in children and adolescents living with type 1 diabetes Kyrgyzstan, Mali, Tanzania, and Peru
ABSTRACT
Background:
Caregivers play an important role in the management of type 1 diabetes (T1DM) for children and adolescents. Controlling blood glucose levels is an essential part of diabetes management. Previous studies have examined access to glucose monitoring devices and health system constraints in low- and middle-income countries and found that in many low- and middle-income countries (LMIC) tools for measuring blood glucose are unavailable and unaffordable. However, very little is known on the perception of caregivers in LMICs with regards to the important element of Self-Management of Blood Glucose (SMBG) and the emerging technologies and their suitability for these contexts.
Objective:
The aim of this article will be to explore caregivers’ perceptions on how SMBG impacts to everyday life. For the purpose of this study the term caregiver is used referring to either a parent or an adult responsible for assisting with the management T1D with the child/adolescent
Methods:
This qualitative descriptive study involved 24 interviews with a caregiver (either a parent or adults responsible for assisting with the management T1D with the child/adolescent) and a child or an adolescent living with T1DM identified through a mix of purposive and snowball sampling. Interviews were carried out based on common themes from a couple interview guide. This study was part of a larger study conducted in Kyrgyzstan, Mali, Peru and Tanzania. Interviews were analyzed using thematic analysis.
Results:
The 24 couple interviews included 18 caregivers of minors living with T1D and 6 adolescents living with T1D. Across settings, caregivers described substantial psychological burden linked to repeated finger pricks, financial strain, and challenges managing diabetes during school and nighttime periods. The tools used raised issues for Blood Glucose Meters (BGM) of finger pricks, follow-up and affordability. Whereas for Continuous Glucose Monitors (CGM) issues of acceptability, accessibility and affordability of these devices was raised by the interviewees. Interviewees also highlighted different disruptions to daily life due to T1DM such as nutrition, school, and the need to access to medical care.
Conclusions:
Caregivers’ perspectives on blood glucose monitoring highlighted the psychological and financial burden that weighs on them. Technological solutions, such as CGM, make it possible to alleviate certain obstacles of using a BGM and strips, but given their high cost can notably increase the financial burden. Clinical Trial: N/A
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