Purpose of Review This review provides a recent update of behavioral research pertinent to young children with T1D and addresses current priorities and future directions. Recent Findings Rates of type 1 diabetes (T1D) in young children (ages 1–7) are continuing to rise. Since 2014, changes to diabetes care and management have impacted young children and reinforced the need for increased attention and interventions to support diabetes management, especially in caregivers who are primarily responsible for their young child’s diabetes management. Summary T1D is associated with unique physiologic challenges in young children, with constant management demands elevating parental diabetes-related stress and fear of hypoglycemia. Diabetes technology use has significantly increased in young children, contributing to improvements in glycemic levels and parent and child psychosocial functioning. Yet despite the positive outcomes demonstrated in select clinical behavioral interventions, research with this young child age group remains limited in scope and quantity.
Purpose: The purpose of this study was to understand impacts of the coronavirus (COVID-19) pandemic on pediatric type 1 diabetes management. Methods: In-depth qualitative interviews were conducted with 15 parents of children (age 6-12 years) with type 1 diabetes. Parents responded to 8 open-ended questions about their experiences managing their children’s type 1 diabetes during the COVID-19 pandemic. All interviews were transcribed, coded, and analyzed using qualitative thematic methods. Results: Parents reported both positive and negative aspects of managing their children’s type 1 diabetes during the COVID-19 pandemic. Facilitators of diabetes management included spending more time together at home and enhanced convenience of telehealth appointments and online supply ordering. Parents also described difficulties managing their children’s type 1 diabetes during the COVID-19 pandemic, including a lack of structure in their child’s daily routine, which led to increases in sedentary behavior. Furthermore, they reported psychosocial challenges of type 1 diabetes management, which were exacerbated by the pandemic. Conclusion: While the COVID-19 pandemic was described as having overall positive impacts on pediatric type 1 diabetes management, efforts to support parents in increasing children’s physical activity and reducing screen time are needed, along with readily accessible mental health resources for both parents and their children with type 1 diabetes.
Introduction: Use of hybrid closed-loop insulin delivery systems have been associated with better glycemic control and lower hemoglobin A1c (HbA1c) values, and better glycemic control is linked with less diabetes-specific family conflict among adolescents with type 1 diabetes (T1D). Little is known, however, about how the use of closed-loop systems relates to diabetes family conflict. Methods: Participants included 60 teens ages 13-17 who had been diagnosed with T1D for ≥1 year and who reported at least moderate diabetes distress (M age= 16.15±1.4, 68% white, non-Hispanic 68% female), and their parents (78% white, non-Hispanic, 78% Married, 83% female). As part of baseline data collection of an ongoing two-site trial of a behavioral intervention, parents and teens each reported on diabetes device use and diabetes-related family conflict. HbA1c values were obtained from teens’ medical records or mail-in kits. Nonparametric (Mann-Whitney) tests were conducted to examine differences between parent and teen-reported diabetes family conflict and HbA1c in relation to use of closed-loops systems. Results: Of the participants, 12 teens (20%) were using a closed-loop system. The use of closed-loop systems was associated with lower levels of parent-reported diabetes-related family conflict (z= -2.372, p=0.018). Use of closed-loop systems was also associated with lower HbA1c values (z= -2.865, p=.004). However, teens’ own report of family conflict was not significantly related to use of the closed-loop systems (z= -1.331, .183). Conclusion: Results suggest that the use of closed-loop systems is associated with both lower HbA1c and lower parent perceptions of diabetes-related family conflict. While future studies are needed to replicate these findings in larger samples and over time, our findings further support that closed-loop systems may reduce the burden of diabetes - particularly for parents - and improve both psychosocial and glycemic outcomes in families of youth with T1D. Disclosure H. R. Moore: None. S. S. Jaser: None. R. Streisand: None. H. Inverso: None. T. Morrow: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK121316)
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