What People with Type 1 Diabetes in South Africa Really Think About Continuous Glucose Monitoring

Continuous Glucose Monitoring (CGM) represents a significant advancement in diabetes care. Instead of checking blood sugar with finger pricks several times a day, CGM devices provide real-time insights into glucose levels throughout the day and night. While CGM has improved diabetes management in many parts of the world, it remains underused in low- and middle-income countries like South Africa.

Researchers wanted to understand why. Between July 2024 and February 2025, they conducted conversations with 107 participants across Cape Town and Pretoria: 75 people living with Type 1 diabetes, 17 caregivers, and 15 healthcare providers working in public sector settings.

The study found broad acceptance of CGM technology. People with Type 1 diabetes appreciated the convenience of continuous monitoring and the reduction in finger-prick testing. Perhaps most importantly, CGM helped them understand their glucose patterns in ways they couldn't before—showing how food, activity, stress, and other factors affect their blood sugar in real time.

When people had access to training and social support—whether from healthcare providers, family, or other people using CGM—they found the devices easier to use and incorporate into their routines. This hands-on support made a real difference in how well people could manage the technology.

Despite the benefits, significant obstacles prevent many people from using CGM in South Africa's public healthcare system. Cost emerged as a primary barrier. CGM devices and supplies require ongoing financial investment that many households simply cannot afford.

Beyond cost, the researchers identified interconnected challenges rooted in poverty and limited resources. Food insecurity—not knowing where the next meal will come from—makes diabetes management more complex. Lack of reliable transportation makes it difficult to reach healthcare appointments or pick up supplies. Limited awareness about CGM among both the public and some healthcare providers also plays a role.

These barriers don't exist in isolation. A person struggling with food insecurity and transportation may not be in a position to benefit from CGM technology, no matter how willing they are to try it. Addressing CGM access in South Africa requires tackling these underlying conditions.

This study offers a realistic picture of CGM adoption in a resource-limited setting. Healthcare providers, people with Type 1 diabetes, and caregivers generally agree that CGM is a valuable tool. The technology itself is acceptable and feasible when circumstances allow.

However, the gap between what's beneficial and what's accessible remains wide. Efforts to expand CGM use in South Africa and similar settings will need to address not just technology training, but also affordability, awareness, and the broader social and economic factors that affect diabetes management.

Source: PloS one. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.