Addala Ananta, Ritter Victor, Schneider-Utaka Aika K, Alamarie Selma A, Pang Erica, Balistreri Ilenia, Shaw Blake, Bishop Franziska K, Zaharieva Dessi P, Prahalad Priya, Desai Manisha, Maahs David M, Hood Korey K
Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA.
Stanford Diabetes Research Center, Stanford University, Stanford, California, USA.
Diabetes Obes Metab. 2025 Feb;27(2):933-943. doi: 10.1111/dom.16093. Epub 2024 Nov 27.
Psychosocial impacts of early continuous glucose monitoring (CGM) initiation in youth soon after type 1 diabetes diagnosis are underexplored. We report parent/guardian and youth patient-reported outcomes (PROs) that measure psychosocial states for families in 4T Study 1.
Of the 133 families in the 4T Study 1, 132 parent/guardian and 66 youth (≥11 years) were eligible to complete PROs. PROs evaluated included diabetes distress, global health, diabetes technology attitudes and CGM benefits/burden scales. Temporal trends of PROs were assessed via generalised linear mixed effects regression. Sociodemographic and clinical characteristics associated with PROs were evaluated. Psychosocial associations were evaluated by regressing parental distress on youth distress.
PRO completion rates were 85.6% and varied between parent/guardian and youth. Throughout the study, parent/guardian and youth distress remained low and youth had increased technology acceptance (p = 0.046). Each additional month of CGM use was associated with a 14% decrease in the odds of experiencing diabetes distress (aOR = 0.86, 95% CI [0.76, 0.99], p = 0.029). Additionally, higher time-in-range was associated with decreased diabetes distress (p = 0.048). Age, diabetic ketoacidosis at diagnosis, gender, ethnicity, insurance status and language spoken were not associated with PROs.
Initiation of CGM shortly after type 1 diabetes diagnosis does not have unintended negative psychological consequences. Longer duration of CGM use was associated with decreased youth distress and technology acceptance increased throughout the study.
1型糖尿病诊断后不久即开始对青少年进行早期持续血糖监测（CGM）的社会心理影响尚未得到充分研究。我们报告了4T研究1中测量家庭社会心理状态的家长/监护人及青少年患者报告结局（PROs）。
4T研究1中的133个家庭中，132名家长/监护人及66名青少年（≥11岁）有资格完成PROs。评估的PROs包括糖尿病困扰、整体健康、糖尿病技术态度以及CGM益处/负担量表。通过广义线性混合效应回归评估PROs的时间趋势。评估与PROs相关的社会人口统计学和临床特征。通过将家长困扰与青少年困扰进行回归分析来评估社会心理关联。
PROs完成率为85.6%，家长/监护人与青少年之间存在差异。在整个研究过程中，家长/监护人和青少年的困扰程度仍然较低，青少年对技术的接受度有所提高（p = 0.046）。CGM使用时间每增加一个月，经历糖尿病困扰的几率就会降低14%（调整后比值比 = 0.86，95%置信区间[0.76, 0.99]，p = 0.029）。此外，血糖在目标范围内的时间越长，糖尿病困扰程度越低（p = 0.048）。年龄、诊断时的糖尿病酮症酸中毒、性别、种族、保险状况和所讲语言与PROs无关。
1型糖尿病诊断后不久开始使用CGM不会产生意外的负面心理后果。在整个研究过程中，CGM使用时间越长，青少年困扰程度越低，对技术的接受度越高。
