At present, little is known about the relationship between emotional well-being and use of diabetes technology, such as closed loop control. This study examined the association between diabetes-related distress and technology opinions/experience in a cohort of people with type 1 diabetes participating in a CLC clinical trial. The trial involved use of sensor-augmented pump (SAP) therapy, overnight only CLC (ON CLC), and 24-hr CLC (24/7 CLC) over 8-week treatment periods. Participants (n=61, 60% F, age= 42.5 ± 11.6, T1D ys = 22.1 ± 12, BMI=29.6 ± 5.5, HbA1c at baseline = 7.4 ± 1.0 TDI/kg = 0.6 ± 0.2) completed the Diabetes Distress Scale (DDS) at baseline and the Closed Loop User Opinion Survey (CLUOS) following each treatment condition. The CLUOS was validated using factor analysis which yielded two subscales describing positive and negative experiences with the technologies (i.e., benefits and barriers), with all items loading .32 or higher on their respective subscales, and Cronbach’s α coefficients of .95 and .93, respectively. Participants were divided into two groups based on baseline DDS scores using the median score to create high and low distress groups for each DDS subscale. T-tests were used to compare CLUOS subscale scores in the high and low DDS groups. There were no differences on the Regimen, Physician or Interpersonal DDS subscales. However, individuals scoring higher on the Emotional DDS subscale at baseline had higher scores on the Negative CLUOS subscale after the SAP (p=0.024) and the ON CLC (p=0.039) conditions, and a trend toward higher Negative scores after the 24/7 CLC (p=0.061). Although preliminary, these findings suggest that higher levels of emotional diabetes distress should be considered and perhaps addressed prior to implementing new diabetes technologies and that higher emotional distress levels may increase the probability of negative experiences with technology, possibly limiting its uptake and use.
L. Gonder-Frederick: Employee; Self; HFS-Global. Research Support; Self; Dexcom, Inc., Jaeb Center for Health Research, Tandem Diabetes Care. Speaker’s Bureau; Self; Diabetes UK. Stock/Shareholder; Self; BeHealth Solutions. A. Bisio: None. S.A. Brown: Research Support; Self; Ascensia Diabetes Care, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care. L.L. Kollar: None. E. Emory: None. B. Kovatchev: Advisory Panel; Self; Sanofi. Board Member; Self; TypeZero Technologies, Inc. Consultant; Self; Sanofi, Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc. Stock/Shareholder; Self; TypeZero Technologies, Inc. Other Relationship; Self; Johnson & Johnson, Sanofi.
National Institutes of Health (R01DK085623); Roche Diagnostics; Tandem Diabetes Care, Inc.; Dexcom, Inc.