Patterns of Continuous Glucose Monitor Use in Young Children Throughout the First 18 Months Following Type 1 Diabetes Diagnosis

Sinisterra, Manuela; Wang, Christine H.; Marks, Brynn E.; Barber, John R.; Tully, Carrie; Monaghan, Maureen; Hilliard, Marisa E.; Streisand, Randi

doi:10.1089/dia.2021.0183

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…16 It is also possible that parents who seek out CGMs early may have higher baseline worry. 24 These patterns have not been previously published in the new diagnosis period. Parents who adopt CGMs soon after diagnosis may be more aware of blood glucose fluctuations, and it is plausible that this increased data may influence how parents respond to young child mealtime behaviors, such as food refusal or leaving the table.…”

Section: Discussionmentioning

confidence: 89%

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Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes

Gonynor

Wang

Tully

et al. 2022

J Dev Behav Pediatr

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Objective: Managing young children's mealtime concerns can be challenging after type 1 diabetes (T1D) diagnosis because of developmental factors and diabetes management demands. To identify potential intervention targets, we evaluated medical, psychosocial, and demographic factors in relation to parents' engagement in problem mealtime behaviors (e.g., pressure to eat, restriction). Method: Parents (N 5 157) of young children (age 1-6 years) reported on psychosocial variables (parent fear of hypoglycemia, family functioning, parent problem solving, and parents' problem mealtime behavior frequency and perceptions of being problematic) within 2 months after T1D diagnosis. Hierarchical regression analyses examined associations among psychosocial variables, demographics (child sex, parent race/ethnicity), child continuous glucose monitor (CGM) use, and parents' problem mealtime behaviors. Results: Parents of children using CGMs reported parents' mealtime behaviors as more problematic than nonusers, but there were no differences for other medical or demographic variables. Models predicting parents' problem mealtime behavior frequency and problem perceptions that included psychosocial variables, demographic variables, and CGM use led to significant R 2 of 0.14 and 0.16, respectively. CGM use and parent problem solving were significantly associated with parent mealtime behaviors being perceived as more problematic. Conclusion: Shortly after T1D diagnosis in young children, medical and parent psychosocial factors related to how frequently parents engaged in problem mealtime behaviors and the degree to which parents perceived them as problematic. Other factors may further explain the complexities of mealtime management. Considering parents' problem-solving skills and child treatment regimens may help guide interventions targeting mealtime challenges during the new diagnosis period.

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Section: Discussionmentioning

confidence: 89%

“…The child's CGM use at baseline was corroborated by medical records, with rates and patterns of CGM use in this sample reported previously. 24…”

Section: Demographic and Medical Variablesmentioning

confidence: 99%

Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes

Gonynor

Wang

Tully

et al. 2022

J Dev Behav Pediatr

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“…The possible links between CGM and sleep have several potential moderating factors, which we could not disentangle. There may be differences in the sociodemographic and other characteristics of families who use CGM compared to those who do not, 16 including among the families in this sample 17 . There is a need to explore further the role of diabetes technology in sleep as literature is minimal and has conflicting evidence 3,18,19 …”

Section: Discussionmentioning

confidence: 97%

Up all night? Sleep disruption in parents of young children newly diagnosed with type 1 diabetes

et al. 2022

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Background: Despite the known challenges of parental adjustment to new-onset type 1 diabetes (T1D) in young children, little is known about parental sleep soon after diagnosis. Methods: Parents (n = 157) of young children (4.5 ± 1.6 years) with new-onset T1D (29 ± 15 days) self-reported their sleep (Pittsburgh Sleep Quality Index, PSQI) at the baseline of a behavioral randomized control trial. We examined sleep patterns and relations with continuous glucose monitor (CGM) use.Results: Over two-thirds (68.8%) reported poor sleep quality (PSQI > 5, M = 8.3 ± 4.1). The mean reported sleep duration was 5.9 ± 1.4 h/night. PSQI scores did not significantly differ by CGM use.Conclusions: Sleep disruption is a pervasive self-reported problem among parents of

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“… 62 An important factor regarding cost is the insurance status, with private insurance being a significant predictor of consistent CGM usage. 63 This was found to be in part mediated by prescription biases, as found by one study in a pediatric provider cohort 64 and another in both the pediatric and adult provider cohorts. 65 Both studies employed vignettes that differed in either public or private insurance status, and both found their cohort to be biased against public insurance (84.6% and 61% of the cohort, respectively).…”

Section: The Influences Of Ses Social Context and Ethnicitymentioning

confidence: 88%

The impact of socioeconomic factors, social determinants, and ethnicity on the utilization of glucose sensor technology among persons with diabetes mellitus: a narrative review

Been,

Lameijer,

Gans

et al. 2024

Therapeutic Advances in Endocrinology

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Continuous glucose monitoring (CGM) usage has been shown to improve disease outcomes in people living with diabetes by facilitating better glycemic management. However, previous research has suggested that access to these devices can be influenced by nonmedical factors such as socioeconomic status and ethnicity. It is critical that equitable access to CGM devices is ensured as people from those groups experience poorer diabetes-related health outcomes. In this narrative review, we provide an overview of the various healthcare systems worldwide and how socioeconomic status, social context, and ethnicity shape device usage and the associated health outcomes. In general, we found that having a lower socioeconomic status and belonging to an ethnic minority group negatively impact CGM usage. While financial means proved to be an important mediator in this process, it was not the sole driver as disparities persisted even after adjustment for factors such as income and insurance status. Recommendations to increase CGM usage for people of a lower socioeconomic status and ethnic minorities include increasing the availability of financial, administrative, and educational support, for both patients and healthcare providers. However, recommendations will vary due to local country-specific circumstances, such as reimbursement criteria and healthcare ecosystems.

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Patterns of Continuous Glucose Monitor Use in Young Children Throughout the First 18 Months Following Type 1 Diabetes Diagnosis

Cited by 6 publications

References 27 publications

Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes

Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes

Up all night? Sleep disruption in parents of young children newly diagnosed with type 1 diabetes

The impact of socioeconomic factors, social determinants, and ethnicity on the utilization of glucose sensor technology among persons with diabetes mellitus: a narrative review

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