Researchers looked at 31 studies testing continuous glucose monitors (CGM)—devices that track blood sugar levels—to see which teaching methods and support strategies help people stick with them and improve their health. They found that successful programs use a mix of real-time feedback, clear instructions, and social support. However, surprisingly, no single technique stood out as the clear winner for lowering blood sugar levels. This research helps doctors and app developers understand what combination of tools might work best when helping people manage their health with glucose monitoring technology.

The Quick Take

  • What they studied: Which teaching methods and support strategies help people use continuous glucose monitors and improve their blood sugar control
  • Who participated: 31 research studies involving adults using continuous glucose monitors, with 35 different intervention programs and 29 comparison groups
  • Key finding: Successful programs used an average of 7 different teaching and support techniques, with real-time feedback, clear instructions, and social support being the most common. However, no single technique was proven to be the most important for lowering blood sugar.
  • What it means for you: If you use a glucose monitoring app or device, programs that combine multiple support methods—like feedback, clear instructions, and encouragement from others—may be more helpful than programs using just one approach. Talk to your doctor about which features matter most for your situation.

The Research Details

Researchers reviewed 31 previous research studies that tested continuous glucose monitors in adults. They carefully examined what teaching methods and support strategies each study used by checking them against a detailed list of 93 possible behavior-change techniques. They looked at both the programs being tested and the comparison groups to see what was different between them.

The researchers then used statistics to see if any particular teaching method or support strategy was connected to better blood sugar results. They measured success by looking at HbA1c levels—a test that shows average blood sugar control over three months.

Understanding which teaching methods and support strategies actually work is important because continuous glucose monitors are becoming more popular, but there’s a lot of confusion about how to use them effectively. By identifying what successful programs have in common, researchers can help create better apps and programs that are more likely to help people manage their health.

This is a secondary analysis of a scoping review, which means researchers looked at existing studies rather than conducting new experiments. The strength of this approach is that it examines real-world programs that have already been tested. The limitation is that the researchers couldn’t control all the differences between studies, and they relied on information that was already published. Only 4 of the 31 studies clearly explained the theory behind their approach, which suggests many programs weren’t designed with a clear scientific framework.

What the Results Show

Researchers found 40 different teaching and support techniques being used across the 31 studies. Programs that tested new approaches used an average of 7 different techniques, while comparison programs (the standard care) used about 5 techniques on average.

The most common techniques in successful programs were: (1) Real-time feedback showing people their blood sugar levels (used in 100% of programs), (2) Teaching people how to use the device correctly (used in 54% of programs), and (3) Having trusted experts explain why the program works (used in 40% of programs).

Other frequently used support methods included feedback and monitoring (100% of programs), teaching knowledge about blood sugar (80% of programs), and social support like encouragement from family or support groups (63% of programs).

Interestingly, when researchers looked at which specific techniques were most connected to better blood sugar control, they didn’t find any single technique that clearly stood out as the most important. This suggests that the combination of techniques working together may be more important than any one technique alone.

The research showed that only 13% of studies clearly stated which scientific theory they were based on, and only 16% explained how they thought their program would create change. When theories were mentioned, they usually focused on building people’s confidence in their ability to manage their health. This suggests that many programs are designed by trial-and-error rather than following a clear scientific plan.

This research builds on previous work showing that continuous glucose monitors can help people manage their blood sugar, but it goes deeper by asking ‘what exactly makes these programs work?’ Previous research didn’t clearly identify which teaching methods matter most. This study suggests that successful programs use multiple techniques together, which is different from assuming one technique is the key to success.

The main limitation is that this review looked at studies that were already published, so researchers couldn’t control how each study was designed. Some studies may have included techniques that weren’t clearly described in their reports, so researchers might have missed them. Additionally, the studies measured success in different ways, making it hard to compare results directly. The fact that no single technique clearly improved blood sugar levels might mean that the combination of techniques matters more than individual ones, but the research design couldn’t prove this definitively.

The Bottom Line

If you’re using or considering a continuous glucose monitor app or program, look for one that includes multiple support features: clear real-time feedback about your blood sugar, easy-to-follow instructions on how to use the device, and opportunities for support from others (family, friends, or support groups). While no single feature is proven to be the most important, programs combining several of these elements appear more effective. Confidence level: Moderate—based on analysis of existing studies rather than new research.

This research is most relevant for people with diabetes or prediabetes who are considering using continuous glucose monitors, healthcare providers designing programs around these devices, and app developers creating glucose monitoring applications. It’s less relevant for people who don’t use glucose monitors or those with type 1 diabetes using insulin pumps with integrated glucose monitoring.

Based on the studies reviewed, people typically see changes in blood sugar control (measured by HbA1c) within 3 months of starting a well-designed program. However, building lasting habits usually takes 6-12 months. Results vary significantly between individuals depending on how consistently they use the device and follow recommendations.

Want to Apply This Research?

  • Track weekly adherence to your glucose monitoring device (aim for 80%+ days with active monitoring) and note which app features you use most (feedback notifications, educational content, or social sharing). This helps identify which support methods work best for you personally.
  • Start by enabling real-time feedback notifications in your app and completing the initial setup instructions. Then add one support feature at a time—such as sharing progress with a family member or joining a support group—rather than trying to use everything at once. This helps you see which combinations work best for your lifestyle.
  • Check your app’s feedback features weekly to see patterns in your blood sugar levels. Every month, review which teaching materials or support features you actually used, and adjust your program to focus on the ones that fit your life best. Share your progress with your healthcare provider every 3 months to see if your blood sugar control is improving.

This research analyzes existing studies about continuous glucose monitoring programs and does not provide medical advice. Continuous glucose monitors and behavior change programs should only be started under the guidance of a qualified healthcare provider. Results vary significantly between individuals based on their specific health conditions, medications, and lifestyle. If you have diabetes or are considering using a continuous glucose monitor, consult with your doctor or diabetes educator to determine if it’s appropriate for you and which program features would be most beneficial for your situation. This summary is for educational purposes and should not replace professional medical advice.