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


ABSTRACT:

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.

SUBMITTER: Faulds ER 

PROVIDER: S-EPMC8530879 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

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

Faulds Eileen R ER   Grey Margaret M   Tubbs-Cooley Heather H   Hoffman Robert P RP   Militello Lisa K LK   Tan Alai A   Happ Mary Beth MB  

Pediatric diabetes 20210815 7


<h4>Objective</h4>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.<h4>Research design and methods</h4>Youth (10-18 years o  ...[more]

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