IMPORTANCE A low-burden electronic health record (EHR) workflow has been devised to systematize the collection and validation of 6 key diabetes self-management habits: (1) checks glucose at least 4 times/day or uses continuous glucose monitor (CGM); (2) gives at least 3 rapidacting insulin boluses per day; (3) uses insulin pump; (4) delivers boluses before meals; (5) reviewed glucose data since last clinic visit, and (6) has changed insulin doses since the last clinic visit. OBJECTIVE To describe the performance of these habits and examine their association with hemoglobin A 1c (HbA 1c ) levels and time in range (TIR).
DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included individuals with known type 1 diabetes who were seen in a US pediatric diabetes clinic in 2019.
MAIN OUTCOMES AND MEASURESHabit performance, total habit score (sum of 6 habits per person), HbA 1c levels, and TIR. RESULTS Of 1344 patients, 1212 (609 [50.2%] males; 66 [5.4%] non-Hispanic Black; 1030 [85.0%] non-Hispanic White; mean [SD] age, 15.5 [4.5] years) were included, of whom 654 (54.0%) were using CGM and had a TIR. Only 105 patients (8.7%) performed all 6 habits. Habit performance was lower among older vs younger patients (age Ն18 years vs Յ12 years: 17 of 411 [4.1%] vs 57 of 330 [17.3%]; P < .001), Black vs White patients (3 [4.5%] vs 95 [9.2%]; P < .001), those with public vs private insurance (14 of 271 [5.2%] vs 91 of 941 [9.7%]; P < .001), and those with lower vs higher parental education levels (
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