Continuous Glucose Monitoring in Adolescents with Type 1 Diabetes: Impact on Quality of Life, Physical Activity, and Health Education: A Narrative Review

Abstract

Background: Adolescence introduces unique clinical, biological, and psychosocial complexities to type 1 diabetes (T1D) management. While continuous glucose monitoring (CGM) systems significantly improve metabolic outcomes, their impact on the overall quality of life (QoL) and psychological well-being remains nuanced.

Objective: This narrative review synthesizes current literature on the effects of CGM on QoL, psychosocial dynamics, and physical activity in adolescents with T1D, aiming to identify optimal strategies for integrated care.

Methods: A comprehensive search of PubMed, Scopus, and Web of Science (2015–2026) was conducted. Inclusion criteria covered peer-reviewed studies assessing CGM use, metabolic control, health-related QoL, and behavioral outcomes in pediatric populations and their caregivers.

Results: CGM use optimizes metabolic control by increasing time in range (TIR) and reducing hypoglycemia, particularly when integrated with automated insulin delivery (AID) systems. However, technological implementation alone does not guarantee improved QoL. This phenomenon can be framed as a “paradox of technological burden,” emerging through decision fatigue , alarm fatigue, and potential peer stigmatization. Therapeutic success heavily relies on subjective satisfaction, the perceived balance of benefits and burdens (the ABC Model), and socioeconomic equity. Furthermore, while CGM facilitates vigorous physical activity, it may induce a behavioral paradox characterized by technological over-reliance and reduced hypoglycemia avoidance behaviors.

Conclusions: CGM is a clinical milestone in T1D care, but maximizing its potential requires a shift from purely metabolic endpoints to holistic, patient-centered metrics. Addressing current literature gaps demands standardized psychometric tools and longitudinal, diverse cohorts. Routine mental health screening, family-centered health education, and equitable access policies are crucial for successful therapy.