Psychosocial outcomes in a diverse sample of youth and their families who initiated continuous glucose monitoring within the first year of type 1 diabetes diagnosis

Ananta Addala; Victor Ritter; Aika K Schneider-Utaka; Selma A Alamarie; Erica Pang; Ilenia Balistreri; Blake Shaw; Franziska K Bishop; Dessi P Zaharieva; Priya Prahalad; Manisha Desai; David M Maahs; Korey K Hood; 4T Team

doi:10.1111/dom.16093

Psychosocial outcomes in a diverse sample of youth and their families who initiated continuous glucose monitoring within the first year of type 1 diabetes diagnosis

Diabetes Obes Metab. 2024 Nov 27. doi: 10.1111/dom.16093. Online ahead of print.

Authors

Affiliations

¹ Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA.
² Stanford Diabetes Research Center, Stanford University, Stanford, California, USA.
³ Division of Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, California, USA.

PMID: 39604317
DOI: 10.1111/dom.16093

Abstract

Aims: Psychosocial impacts of early continuous glucose monitoring (CGM) initiation in youth soon after type 1 diabetes diagnosis are underexplored. We report parent/guardian and youth patient-reported outcomes (PROs) that measure psychosocial states for families in 4T Study 1.

Materials and methods: Of the 133 families in the 4T Study 1, 132 parent/guardian and 66 youth (≥11 years) were eligible to complete PROs. PROs evaluated included diabetes distress, global health, diabetes technology attitudes and CGM benefits/burden scales. Temporal trends of PROs were assessed via generalised linear mixed effects regression. Sociodemographic and clinical characteristics associated with PROs were evaluated. Psychosocial associations were evaluated by regressing parental distress on youth distress.

Results: PRO completion rates were 85.6% and varied between parent/guardian and youth. Throughout the study, parent/guardian and youth distress remained low and youth had increased technology acceptance (p = 0.046). Each additional month of CGM use was associated with a 14% decrease in the odds of experiencing diabetes distress (aOR = 0.86, 95% CI [0.76, 0.99], p = 0.029). Additionally, higher time-in-range was associated with decreased diabetes distress (p = 0.048). Age, diabetic ketoacidosis at diagnosis, gender, ethnicity, insurance status and language spoken were not associated with PROs.

Conclusions: Initiation of CGM shortly after type 1 diabetes diagnosis does not have unintended negative psychological consequences. Longer duration of CGM use was associated with decreased youth distress and technology acceptance increased throughout the study.

Keywords: continuous glucose monitoring; diabetes distress; diabetes technology; global wellbeing; new onset diabetes; patient reported outcomes.

Abstract

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