Letter: Insight on Acceptability of Continuous Glucose Monitoring in Youth-Onset Type 2 Diabetes

To the Editor,

I’ve spent over 4 years working with teenagers managing type 2 diabetes, and rarely does a study resonate so deeply with the daily struggles I witness in my clinic. The recent pilot trial titled, “Continuous Glucose Monitoring Use in Youth with Type 2 Diabetes: A Pilot Randomized Study,” ¹ struck a chord—not just for its scientific rigor but also for how it mirrors the quiet battles many of my patients face. Let me explain why this work matters and where it leaves us with more questions than answers.

First, the good news: the trial’s recruitment of youth from predominantly Black and female backgrounds is a breath of fresh air. For too long, diabetes technology research has treated Y-T2D as an afterthought, despite its devastating rise in marginalized communities. The fact that 78.8% of continuous glucose monitor (CGM) users maintained ≥80% wear time by the study’s end is no small feat. ² But let’s not gloss over the human story behind those numbers.

Then there’s the physical toll. Participants experienced skin irritation from adhesives. ³ Imagine being a teenager already self-conscious about weight or acne, now adding raw, itchy patches to the mix. One mother told me her son refused to wear his CGM after a rash left scar: “He said diabetes is stealing enough from him.” These aren’t minor “adverse events”—they’re daily reminders of a disease that refuses to stay invisible.

So where do we go from here? A few ideas, shaped by late-night clinic musings and patient whispers:

Design with teens, not for them. Involve youth in creating discreet, skin-friendly sensors. (Maya suggests a tattoo-style monitor: “Make it look cool, not medical.”)

Acknowledge the emotional labor. Pair CGM with counseling to address stigma or peer groups where kids can vent about device annoyances.

Chase bigger systemic changes. Even the best CGM can’t offset poverty or racism—but it can be a catalyst for advocacy.

This trial is a critical wake-up call: technology alone won’t save us. But if we listen—truly listen—to these young voices, we might just build tools that don’t add to their burdens but lighten them.

Gratefully,

Shahzaib Shahzaib