711-P: A Qualitative Exploration of Beliefs and Attitudes about Food Choices for Diabetes Self-Management among Adults with Type 1 Diabetes

Introduction & Objective: More than 1.7 million adults in the U.S. live with type 1 diabetes (T1D), which requires daily management to maintain optimal glycemic levels and prevent serious complications. Daily self-management may lead to obsessionality over food choices and therefore affect self-management behaviors. For example, some adults with T1D may delay hypoglycemia treatment due to beliefs about fast-acting carbohydrates, while others may restrict particular foods or food groups to achieve glycemic control. This qualitative study explored the tension between food choices and beliefs about healthy living among adults with T1D.

Methods: As part of a larger study on experiences of hypoglycemia self-management, participants using continuous glucose monitors (CGMs) ≥70% of the time for more than six months were recruited from a Midwest academic medical center. Maximum variation sampling included adults with T1D across different percentages of time spent in level 2 hypoglycemia (glucose level <54 mg/dL). Diabetes history and sociodemographic data were collected. A semi-structured interview explored the thoughts and behaviors of participants using CGMs. Inductive thematic analysis was conducted focusing on relationships with food during self-management.

Results: Preliminary findings include the impact of food characterization (e.g., “healthy” or “unhealthy”) in hypoglycemia treatment, the influence of family/friends on treatment food choices, and ways adults with T1D reconcile their diabetes needs and personal lifestyle goals.

Conclusions: These findings will add to the few studies on the specific responses to dietary intake of adults with T1D, particularly related to self-management. The results suggest the need for more mixed-methods research to understand the role of food beliefs in daily and long-term T1D self-management to inform better diabetes education and interventions.