People with type 1 diabetes make up approximately two million of the American population. Every day, these two million people struggle to fight this lifelong, sometimes life threatening disease. While type 1 diabetes currently has no cure, there are technologies that can make diabetes management more effective. This study surveyed the type 1 diabetes (T1D) young adult population aged 18-30, to evaluate what technologies and tools are most often associated with achieving optimal glycemic control (OGC).
The instrument is a 35 question, investigator developed survey that is designed to measure how often a participant utilizes the technology identified in each question, with the response choices ranging from 0 (never) to 5 (multiple times daily). In addition, there were some yes/no and fill-in-the-blank questions to identify demographic variables. The technology topics that were explored are 1) mode of insulin therapy, 2) mode of blood glucose monitoring therapy, 3) mode of communication with designated care provider, 4) electronic applications used, 5) demographic variables, and 6) pertinent comorbidities. This information was used to evaluate variables that assist T1Ds in achieving optimal glycemic control. Participants were invited to participate in this study via email using the Students with Diabetes email listserv. The email contained the IRB approved explanation of research letter, which informed participants of the study and the research being conducted. If the student chose to participate, they checked a box that served as an electronic signature, and they continued on to the 35-question survey. All responses to the survey will be kept confidential; as the survey and research did not require any personal identifying information. Data regarding the specific demographics, technologies used for diabetes control, and hemoglobin A1C levels were recorded and analyzed. The results of the survey will be shared with the participants via the same email list-serv by which they were originally recruited.
There were 59 participants. A total of 21 out of 59 respondents had optimal glycemic control (A1C less than 7.0, per American Diabetes Association guidelines). Eighty eight percent of those with OGC wore their CGMs all the time, while only 66% of those with IGC wore their CGMs all the time. Ninety five percent of those with OGC used their insulin pumps all the time, while 89% of those with IGC did. It is likely that the combination of both CGMs and insulin pumps worn all the time are the most powerful tools to achieving OGC. Students that were employed, enrolled in classes, and still under their parent’s insurance plans had a higher incidence of optimal glycemic control.
It was hypothesized that those with OGC would have a higher incidence of diabetes technology use. This PI found that even though almost all participants had access to the diabetes technology, still only 37% of the participants had optimal glycemic control. There are many components to diabetes care that impact glycemic control that were not explored within this scope of this diabetes technology study.
It is likely that both CGMs and insulin pumps worn all the time are the most powerful tools to achieving OGC. Students who graduate from college and transition to adulthood are vulnerable as they may encounter added stressors such as employment, and financial responsibility that cause them to deviate from the recommendations for diabetes technology use. Care providers need to be cognizant that young adulthood is a vulnerable time in terms of OGC and optimal diabetes management. Providers need to work with young adults, and encourage them to adhere to the recommended diabetes care regime.
Bachelor of Science in Nursing (B.S.N.)
College of Nursing
Orlando (Main) Campus
Hassett, Shannon L., "Technologies to Enhance Optimal Glycemic Control in Young Adults with Type 1 Diabetes" (2016). Honors in the Major Theses. 30.