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Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop
BACKGROUND. Adolescents and young adults with type 1 diabetes have high HbA1c levels and often struggle with self-management behaviors and attention to diabetes care. Hybrid closed-loop systems (HCL) like the t:slim X2 with Control-IQ technology (Control-IQ) can help improve glycemic control. The pu...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445779/ https://www.ncbi.nlm.nih.gov/pubmed/37614410 http://dx.doi.org/10.1155/2023/1888738 |
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author | Messer, Laurel H. Cook, Paul F. Voida, Stephen Fiesler, Casey Fivekiller, Emily Agrawal, Chinmay Xu, Tian Forlenza, Gregory P. Sankaranarayanan, Sriram |
author_facet | Messer, Laurel H. Cook, Paul F. Voida, Stephen Fiesler, Casey Fivekiller, Emily Agrawal, Chinmay Xu, Tian Forlenza, Gregory P. Sankaranarayanan, Sriram |
author_sort | Messer, Laurel H. |
collection | PubMed |
description | BACKGROUND. Adolescents and young adults with type 1 diabetes have high HbA1c levels and often struggle with self-management behaviors and attention to diabetes care. Hybrid closed-loop systems (HCL) like the t:slim X2 with Control-IQ technology (Control-IQ) can help improve glycemic control. The purpose of this study is to assess adolescents’ situational awareness of their glucose control and engagement with the Control-IQ system to determine significant factors in daily glycemic control. METHODS. Adolescents (15–25 years) using Control-IQ participated in a 2-week prospective study, gathering detailed information about Control-IQ system engagements (boluses, alerts, and so on) and asking the participants’ age and gender about their awareness of glucose levels 2–3 times/day without checking. Mixed models assessed which behaviors and awareness items correlated with time in range (TIR, 70–180 mg/dl, 3.9–10.0 mmol/L). RESULTS. Eighteen adolescents/young adults (mean age 18 ± 1.86 years and 86% White non-Hispanic) completed the study. Situational awareness of glucose levels did not correlate with time since the last glucose check (p = 0.8). In multivariable modeling, lower TIR was predicted on days when adolescents underestimated their glucose levels (r = −0.22), received more CGM alerts (r = −0.31), and had more pump engagements (r = −0.27). A higher TIR was predicted when adolescents responded to CGM alerts (r = 0.20) and entered carbohydrates into the bolus calculator (r = 0.49). CONCLUSION. Situational awareness is an independent predictor of TIR and may provide insight into patterns of attention and focus that could positively influence glycemic outcomes in adolescents. Proactive engagements predict better TIR, whereas reactive engagement predicted lower TIR. Future interventions could be designed to train users to develop awareness and expertise in effective diabetes self-management. |
format | Online Article Text |
id | pubmed-10445779 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
record_format | MEDLINE/PubMed |
spelling | pubmed-104457792023-08-23 Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop Messer, Laurel H. Cook, Paul F. Voida, Stephen Fiesler, Casey Fivekiller, Emily Agrawal, Chinmay Xu, Tian Forlenza, Gregory P. Sankaranarayanan, Sriram Pediatr Diabetes Article BACKGROUND. Adolescents and young adults with type 1 diabetes have high HbA1c levels and often struggle with self-management behaviors and attention to diabetes care. Hybrid closed-loop systems (HCL) like the t:slim X2 with Control-IQ technology (Control-IQ) can help improve glycemic control. The purpose of this study is to assess adolescents’ situational awareness of their glucose control and engagement with the Control-IQ system to determine significant factors in daily glycemic control. METHODS. Adolescents (15–25 years) using Control-IQ participated in a 2-week prospective study, gathering detailed information about Control-IQ system engagements (boluses, alerts, and so on) and asking the participants’ age and gender about their awareness of glucose levels 2–3 times/day without checking. Mixed models assessed which behaviors and awareness items correlated with time in range (TIR, 70–180 mg/dl, 3.9–10.0 mmol/L). RESULTS. Eighteen adolescents/young adults (mean age 18 ± 1.86 years and 86% White non-Hispanic) completed the study. Situational awareness of glucose levels did not correlate with time since the last glucose check (p = 0.8). In multivariable modeling, lower TIR was predicted on days when adolescents underestimated their glucose levels (r = −0.22), received more CGM alerts (r = −0.31), and had more pump engagements (r = −0.27). A higher TIR was predicted when adolescents responded to CGM alerts (r = 0.20) and entered carbohydrates into the bolus calculator (r = 0.49). CONCLUSION. Situational awareness is an independent predictor of TIR and may provide insight into patterns of attention and focus that could positively influence glycemic outcomes in adolescents. Proactive engagements predict better TIR, whereas reactive engagement predicted lower TIR. Future interventions could be designed to train users to develop awareness and expertise in effective diabetes self-management. 2023 2023-05-18 /pmc/articles/PMC10445779/ /pubmed/37614410 http://dx.doi.org/10.1155/2023/1888738 Text en https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Article Messer, Laurel H. Cook, Paul F. Voida, Stephen Fiesler, Casey Fivekiller, Emily Agrawal, Chinmay Xu, Tian Forlenza, Gregory P. Sankaranarayanan, Sriram Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title | Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title_full | Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title_fullStr | Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title_full_unstemmed | Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title_short | Situational Awareness and Proactive Engagement Predict Higher Time in Range in Adolescents and Young Adults Using Hybrid Closed-Loop |
title_sort | situational awareness and proactive engagement predict higher time in range in adolescents and young adults using hybrid closed-loop |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445779/ https://www.ncbi.nlm.nih.gov/pubmed/37614410 http://dx.doi.org/10.1155/2023/1888738 |
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