Introduction & Objective: Many adolescents with T1D experience diabetes distress, which is related to suboptimal glycemic outcomes. PRISM is a skills-based psychosocial intervention that benefitted psychosocial and behavioral outcomes in youth with T1D but did not improve HbA1c. We explored whether PRISM impacted CGM metrics, given the greater glycemic specificity than HbA1c.
Methods: A 2-site, 1:1 RCT of PRISM vs. Usual Care (UC) included youth with T1D aged 13-18y with elevated diabetes distress (Problem Areas in Diabetes - Teen screener score ≥30). In an exploratory analysis of teens using CGM for routine T1D management (n = 114, 66% of total sample had ample CGM data), we used Wilcoxon rank sum exact tests to compare CGM values above, in, and below target range between PRISM vs. UC at baseline, 6, and 12 months.
Results: Table 1 summarizes CGM metrics at each time point. The difference reached statistical significance only for Level 1 Hypoglycemia at 6 months. There were no other significant group differences in CGM metrics.
Conclusion: The reduction in hypoglycemia suggests potential for psychosocial intervention to have glycemic benefit in youth with diabetes distress, though additional strategies are needed to sustain long-term improvement. Larger intervention studies with teens using CGM are needed to evaluate potential for improving CGM-derived glycemic outcomes.
M.L. Ferm: None. D. DeSalvo: Advisory Panel; Insulet Corporation. Consultant; Dexcom, Inc. C. Zhou: None. M. Bradford: None. F. Malik: None. M.B. O'Donnell: None. C. Pihoker: None. A. Rosenberg: None. J.P. Yi-Frazier: None. M.E. Hilliard: None.
National Institutes of Health (R01DK121224); National Institute of Diabetes and Digestive and Kidney Disease (K26DK138332)
