Salient characteristics of youth with type 1 diabetes initiating continuous glucose monitoring

Abstract

Objective: Consistent continuous glucose monitoring (CGM) use is a challenge in youth with type 1 diabetes. This study aimed to investigate patient and family behavioral and clinical characteristics associated with interest in implementing CGM.

Research design and methods: In a cross-sectional study, we compared 120 youth interested in starting CGM (the CGM group) with a general sample of 238 youth with type 1 diabetes (the Standard group). Youth and their parents completed validated surveys assessing adherence to diabetes management, diabetes-specific family conflict, parent involvement in diabetes management, and youth quality of life. Demographic and clinical data were obtained from chart review and interview.

Results: Youth participants had a mean age of 13.0±2.8 years, diabetes duration of 6.3±3.4 years, and hemoglobin A1c (HbA1c) level of 8.2±1.0% (66±11 mmol/mol). Youth in the CGM group performed more frequent blood glucose monitoring, had lower HbA1c levels, and were more likely to be treated by continuous subcutaneous insulin infusion (CSII) and to be living in two-parent homes than youth in the Standard group. Compared with the Standard group, youth interested in wearing a CGM device and their parents reported greater adherence to diabetes management, less diabetes-specific family conflict, and higher youth quality of life. No differences were found between groups with respect to parent involvement in diabetes management by both youth and parent reports.

Conclusions: In efforts to enhance CGM uptake, it is important to address factors such as blood glucose monitoring frequency, CSII use, adherence, and diabetes-specific family conflict when considering youth with type 1 diabetes for CGM implementation.

Figures

FIG. 1.

Youth survey scores by study group. Youth interested in using continuous glucose monitoring (CGM) (the CGM group), in comparison with a general sample of youth with type 1 diabetes (the Standard group), reported, respectively, greater adherence to diabetes care (Diabetes Management Questionnaire [DMQ], 75±10 vs. 72±12), less diabetes-specific family conflict (Diabetes Family Conflict Scale [DFCS], 13±17 vs. 20±23), and higher youth quality of life (Pediatric Quality of Life Inventory [PedsQL], 86±14 vs. 83±12). There were no differences between the CGM and Standard groups regarding parent involvement in diabetes management (Diabetes Family Responsibility Questionnaire [DFRQ], 46±15 vs. 47±16, respectively). *DFCS original scores, prior to normalization: 24.0±6.6 (CGM group) versus 26.6±8.9 (Standard group). **DFRQ original scores, prior to normalization: 32.7±5.0 (CGM group) versus 32.9±5.4 (Standard group).

FIG. 2.

Parent survey scores by study group. Parents of youth interested in using continuous glucose monitoring (CGM) (CGM group), in comparison with parents of youth in a general sample of youth with type 1 diabetes (Standard group), reported, respectively, greater adherence to diabetes care (Diabetes Management Questionnaire [DMQ], 79±11 vs. 75±12), less diabetes-specific family conflict (Diabetes Family Conflict Scale [DFCS], 11±11 vs. 15±12), and higher youth quality of life (Pediatric Quality of Life Inventory [PedsQL], 83±12 vs. 79±13). There were no differences between the CGM and Standard groups regarding parent involvement in diabetes management (Diabetes Family Responsibility Questionnaire [DFRQ], 57±16 vs. 57±17, respectively). *DFCS original scores, prior to normalization: 23.1±4.3 (CGM group) versus 24.6±4.7 (Standard group). **DFRQ original scores, prior to normalization: 36.5±5.5 (CGM group) versus 36.3±5.6 (Standard group).