1. Expect the unexpected: Adolescent and pre-teens' experience of diabetes technology self-management.
- Author
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Faulds ER, Grey M, Tubbs-Cooley H, Hoffman RP, Militello LK, Tan A, and Happ MB
- Subjects
- Adolescent, Blood Glucose Self-Monitoring statistics & numerical data, Child, Diabetes Mellitus, Type 1 blood, Female, Glycated Hemoglobin analysis, Health Behavior, Humans, Insulin therapeutic use, Male, Adolescent Behavior, Diabetes Mellitus, Type 1 drug therapy, Glycemic Control statistics & numerical data, Insulin Infusion Systems statistics & numerical data, Self-Management statistics & numerical data
- 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., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2021
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