Expect the unexpected : Adolescent and pre-teens' experience of diabetes technology self-management

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..

OBJECTIVE: Only 17% of adolescents with type 1 diabetes (T1D) are currently meeting their glycemic targets despite advances in diabetes technologies. Self-management behaviors and challenges specific to use of diabetes technologies are insufficiently studied in adolescents. We aimed to describe the experience of diabetes technology self-management, including facilitators and barriers, among preteens/adolescents with low and high A1C.

RESEARCH DESIGN AND METHODS: Youth (10-18 years of age) with T1D who use insulin pump therapy were recruited from the larger quantitative cohort of a mixed methods study for participation in semi-structured qualitative interviews. Maximum variability sampling was used to recruit youth with A1C <7.5% (n = 5) and A1C >9% (n = 5). Participants' personal insulin pump and continuous glucose monitoring data were downloaded and served as a visual reference. Interviews were analyzed using a qualitative descriptive approach.

RESULTS: Participants were 50% female with a median age of 14.9 years and 80% used CGM. The sample was predominantly white (90.0%). Analysis produced four major themes, Bad Day, Expect the Unexpected, Nighttime Dependence, and Unpredictability, It's Really a Team and interconnecting subthemes. Youth characterized ''Bad Days'' as those requiring increased diabetes focus and self-management effort. The unpredictability (''Expect the Unexpected'') of glucose outcomes despite attention to self-management behaviors was considerable frustration.

CONCLUSIONS: Diabetes devices such as insulin pumps are complex machines that rely heavily on individual proficiency, surveillance, and self-management behaviors to achieve clinical benefit. Our findings highlight the dynamic nature of self-management and the multitude of factors that feed youths' self-management behaviors.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:22

Enthalten in:

Pediatric diabetes - 22(2021), 7 vom: 20. Nov., Seite 1051-1062

Sprache:

Englisch

Beteiligte Personen:

Faulds, Eileen R [VerfasserIn]
Grey, Margaret [VerfasserIn]
Tubbs-Cooley, Heather [VerfasserIn]
Hoffman, Robert P [VerfasserIn]
Militello, Lisa K [VerfasserIn]
Tan, Alai [VerfasserIn]
Happ, Mary Beth [VerfasserIn]

Links:

Volltext

Themen:

Adolescent
Diabetes technology
Glycated Hemoglobin A
Insulin
Insulin pump therapy
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Self-management
Type 1 diabetes

Anmerkungen:

Date Completed 03.02.2022

Date Revised 07.12.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/pedi.13249

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM328094617