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Predictors of Continuous Glucose Mon...

Messer, Laurel Haydon-Smith.

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Predictors of Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Predictors of Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes./
作者:	Messer, Laurel Haydon-Smith.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	126 p.
附註:	Source: Dissertations Abstracts International, Volume: 81-07, Section: B.
Contained By:	Dissertations Abstracts International81-07B.
標題:	Nursing. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27662789
ISBN:	9781392886199

Predictors of Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes.
Messer, Laurel Haydon-Smith.

Predictors of Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 126 p.

Source: Dissertations Abstracts International, Volume: 81-07, Section: B.

Thesis (Ph.D.)--University of Colorado Denver, Anschutz Medical Campus, 2019.

This item must not be sold to any third party vendors.

Background: Type 1 diabetes (T1D) requires lifelong insulin injections and glucose monitoring to reduce long term health complications. Adolescents have the poorest glycemic control of all individuals with T1D, and have difficulty maintaining necessary self-management behaviors. Continuous Glucose Monitors (CGM) are devices that provide near-constant glucose information for the user and can improve glycemic control. However, many adolescents choose not to use CGM consistently. The purpose of this study was to explore predictors of consistent CGM use in adolescents with T1D.Methods: Using data from the T1D Exchange Registry network, adolescents (9-19 years) with T1D who have current or previous CGM experience were surveyed on coping behaviors, perceived benefits and burdens of CGM, self-efficacy, diabetes distress, and family conflict. Demographic and diabetes management information were additionally collected and tested for differences between youth who wore CGM 6-7 days/week ("CGM Optimizers") versus 0-5 days/week ("CGM Sub-Users"). Logistic regression was used to determine predictors of being a CGM Optimizer versus CGM Sub-User, and additional exploratory comparisons were conducted on diabetes distress and family conflict.Results: Of the total 282 adolescents surveyed (54 % female), 161 were classified as CGM Optimizers (mean CGM use = 6.85 +/− 0.32 days/week) and 121 were classified as CGM Sub-Users (mean CGM use = 1.68 +/− 2.3 days/week). In univariate analysis, CGM Optimizers were younger (15.91 +/− 2.17 years v. 16.79 +/− 2.17, p = 0.001), more likely to be non-Hispanic white (91.9% v 83.5%, p = 0.029), and more likely to have private insurance (82.0% v 69.4%, p = 0.009). Every 1-point increase on the Benefits of CGM scale was associated with increase odds of classification as a CGM Optimizer (OR = 2.53, 95% CI 1.548-5.132), and every 1-point increase on the Burdens of CGM scale was associated with decreased odds (OR = 0.464, 95% CI = 0.283-0.800), (p = 0.001 and 0.005 respectively), with the final logistic regression model predicting 22.3% of the variance. Family conflict was significantly lower in CGM Optimizers compared to CGM Sub-users (mean score 26.73+/− 7.67 vs 28.91 +/− 8.41, p = 0.025)Conclusion: CGM Optimizers were more likely to perceive higher benefit and lower burden to CGM than CGM Sub-users, whereas coping behaviors and perceived self-efficacy were not different. Future studies should explore how these perceptions can be modified to increase the consistent use of CGM for adolescents with T1D with the ultimate goal of improving glycemic control.

ISBN: 9781392886199Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Adolescents

Predictors of Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes.
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520 $a Background: Type 1 diabetes (T1D) requires lifelong insulin injections and glucose monitoring to reduce long term health complications. Adolescents have the poorest glycemic control of all individuals with T1D, and have difficulty maintaining necessary self-management behaviors. Continuous Glucose Monitors (CGM) are devices that provide near-constant glucose information for the user and can improve glycemic control. However, many adolescents choose not to use CGM consistently. The purpose of this study was to explore predictors of consistent CGM use in adolescents with T1D.Methods: Using data from the T1D Exchange Registry network, adolescents (9-19 years) with T1D who have current or previous CGM experience were surveyed on coping behaviors, perceived benefits and burdens of CGM, self-efficacy, diabetes distress, and family conflict. Demographic and diabetes management information were additionally collected and tested for differences between youth who wore CGM 6-7 days/week ("CGM Optimizers") versus 0-5 days/week ("CGM Sub-Users"). Logistic regression was used to determine predictors of being a CGM Optimizer versus CGM Sub-User, and additional exploratory comparisons were conducted on diabetes distress and family conflict.Results: Of the total 282 adolescents surveyed (54 % female), 161 were classified as CGM Optimizers (mean CGM use = 6.85 +/− 0.32 days/week) and 121 were classified as CGM Sub-Users (mean CGM use = 1.68 +/− 2.3 days/week). In univariate analysis, CGM Optimizers were younger (15.91 +/− 2.17 years v. 16.79 +/− 2.17, p = 0.001), more likely to be non-Hispanic white (91.9% v 83.5%, p = 0.029), and more likely to have private insurance (82.0% v 69.4%, p = 0.009). Every 1-point increase on the Benefits of CGM scale was associated with increase odds of classification as a CGM Optimizer (OR = 2.53, 95% CI 1.548-5.132), and every 1-point increase on the Burdens of CGM scale was associated with decreased odds (OR = 0.464, 95% CI = 0.283-0.800), (p = 0.001 and 0.005 respectively), with the final logistic regression model predicting 22.3% of the variance. Family conflict was significantly lower in CGM Optimizers compared to CGM Sub-users (mean score 26.73+/− 7.67 vs 28.91 +/− 8.41, p = 0.025)Conclusion: CGM Optimizers were more likely to perceive higher benefit and lower burden to CGM than CGM Sub-users, whereas coping behaviors and perceived self-efficacy were not different. Future studies should explore how these perceptions can be modified to increase the consistent use of CGM for adolescents with T1D with the ultimate goal of improving glycemic control.
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