Introduction: Achieving optimal glycemic control is difficult in children with T1D even with insulin pumps and continuous glucose monitoring (CGM). Additional support focused on improving technology use may improve diabetes management.

Methods: Children aged 2-6 years were enrolled in a 6-month adaptive study design (SMART) utilizing Dexcom G5 CGM. Monthly data were collected to assess time in range (70-180mg/dL) and adherence. If time in range was <60% or adherence was <6 of 7 days worn, participants’ families randomized to one of four interventions focusing on diabetes distress, developmental demands, fear of hypoglycemia, or remote monitoring. Parents completed surveys on diabetes distress, glucose monitoring satisfaction, hypoglycemia fear and confidence at enrollment and study end. HbA1c was collected at study initiation and study end.

Results: Of 77 participants, 52.6% were male, mean age 4.94 ± 1.42y (2.03-7.00), diabetes duration 2.12 ± 1.13y (0.58-4.26). Each participant received an average of 3 intervention sessions. HbA1c decreased and psychological outcomes improved at statistically and clinically significant levels (Table).

Conclusion: Providing interventions that address common diabetes management problem areas may help parents of young children with T1D improve glucose control and quality of life. More work is needed to identify which interventions were associated with the greatest benefit.
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Disclosure

M.S. Lanning: None. L. DiMeglio: Research Support; Self; Amgen Inc., Caladrius Biosciences, Inc., Janssen Research & Development, Medtronic, Sanofi. Other Relationship; Self; Dexcom, Inc. S. Lange: Other Relationship; Self; Medtronic MiniMed, Inc. K.A. Driscoll: None. T.S. Hannon: Advisory Panel; Self; Eli Lilly and Company. A.M. Lagges: None. S. Woerner: None. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Novo Nordisk Inc., Profusa, Inc. Consultant; Self; Medtronic MiniMed, Inc. Research Support; Self; Beta Bionics, ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care. K.K. Hood: Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc. Speaker's Bureau; Self; Johnson & Johnson Diabetes Institute.

Funding

National Institutes of Health

© 2019 by the American Diabetes Association.
2019
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