Sex and intimacy counselling needed to reassure people about diabetes technology

Clinicians should broach the subjects of sex and intimacy when discussing wearable diabetes technology with their patients, even in young people, WA researchers say.

Responses to a survey of people with type 1 diabetes 16-60 years of age showed they did think about how insulin pumps and CGM devices might affect their relationships into the future.

Of the 289 respondents 45% used CSII and 35% used CGM.

About half of the CSII users reported that the pump interfered with sex.

Qualitative responses described the pump getting in the way, interrupting the moment, getting tangled or pulled, and causing issues or interference with their sexual partner.

Three quarters of CSII users (75.2%) said they disconnect their insulin pump to avoid these problems.

In fact, “…20.8% of respondents had used pump disconnection as a signal to their partner that they wanted to engage in sexual activity,” the study authors said.

Fewer people, only 20.2% of sexually active CGM users, said the device interfered with their sexual activity though some worried it might get in the way, come off during sex, or be unattractive and a turn-off.

One in four non-CSII users (25.5%) cited concerns about the impact of diabetes technology on their sexual activities as a reason for not using it.

However the survey found there were no differences between tech users and non-users in terms of anxiety levels, body image, frequency of sexual activity or satisfaction with sex.

“The high proportion of technology users citing sex and intimacy-related concerns as part of the decision to adopt technology is an important finding given that in the authors’ clinical experience, discussions regarding sex and technology use are infrequently raised by clinicians,” the study said.

“The often-expressed reason for not wishing to adopt externally worn technology, such as the hassle of wearing devices and not liking devices on one’s body, may indirectly reflect concerns about intimacy and sex.”

Senior investigator Dr Martin de Bock, formerly at the University of WA now at the University of Otago and Canterbury District Health Board in New Zealand, told the limbic it was a surprise that scores for anxiety and body image were similar in tech users and non-users.

“I thought that non-adopters would be more anxious or have lower body image but I guess the point was, across the board, anxiety levels are really high. We know that; that’s no different, but we didn’t find any difference between these groups.”

“In the end we find there are easy ways to get around it and it doesn’t actually interfere with their sex lives at all. They don’t need to worry about that. We just need to be better at talking to them about it.”

He added that CGM sensors were getting smaller and more discrete so hopefully would become less of an issue.

Dr de Bock said he would advocate for CGM with patients as they were likely to get better glycaemic control.

“I would be arguing for a pump only if it is less burden and some people say having a device attached to them is even more burden.”

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