Gülay Can YILMAZ, Meltem Derya ŞAHİN
Trends in Pediatrics - 2026;7(2):85-93
Background: Mothers of children with type 1 diabetes (T1D) often experience heightened anxiety and caregiver burden due to continuous management tasks and vigilance for hypoglycemia, especially overnight. Continuous glucose monitoring (CGM), by providing real-time glucose information and alerts, may be associated with changes in these psychosocial outcomes beyond glycemic indices. We evaluated whether CGM use is associated with maternal anxiety and caregiver burden and examined its relationship with glycemic control. Methods: In this single-center, comparative cross-sectional study, mothers of children aged 2-18 years with T1D were grouped as CGM users (>=3 months) or non-users (never). Maternal anxiety (STAI-S/T) and caregiver burden (ZBI) were assessed; children's HbA1c and change in HbA1c (DeltaHbA1c) were recorded. Group differences and adjusted associations were examined. Results: A total of 130 mothers were included (CGM n=65; non-CGM n=65); children were 49.2% girls, with a mean age of 11.66 +/- 3.84 years. Groups were generally comparable in sociodemographic and clinical characteristics; paternal education differed and was adjusted for. Diabetes duration was similar between groups: median (IQR) 2.94 (1.87-6.64) vs. 2.96 (1.83-5.99) years, p=0.419. Among mothers of CGM users, mean caregiver burden, state anxiety, and trait anxiety scores were lower than among non-users, and these associations persisted after adjustment for prespecified sociodemographic and clinical covariates. Children using CGM had the lowest most recent HbA1c (7.57 +/- 0.97 vs. 8.20 +/- 1.47). In CGM users, longer use was associated with lower maternal anxiety, whereas caregiver burden did not vary with duration. Neither HbA1c nor DeltaHbA1c independently explained maternal anxiety or burden. Conclusion: Among mothers of children with T1D, CGM use was associated with lower anxiety and caregiver burden, with an inverse association between duration of CGM use and anxiety. These patterns suggest that processes beyond glycemic averages-such as perceived control, alarm management, and day-to-day caregiving demands-may shape maternal well-being. Clinically, CGM counselling may be optimized by tailoring alarm settings and integrating device use into family routines; further multicenter studies with longer follow-up and time-sensitive CGM/psychosocial measures are warranted.
