Changes in Self-Efficacy During COVID-19 Among Adolescents With Type 1 Diabetes Mellitus: A Qualitative Study.
Nkemjika Okonkwo, Erin M Bergner, Sarah S Jaser
PMID 39306780WHAT IT FOUND
Many adolescents and mothers reported higher confidence in diabetes self-management during the pandemic, especially with CGMs and pumps.
Ask families about device alarms, trend data, failures, and conflict, not just glucose numbers.
Key findings
0163% of adolescents and 51% of caregivers reported increased confidence in managing diabetes over the pandemic, and adolescents reported higher confidence than caregivers.
02CGMs and pumps were described as helping adolescents prevent or limit adverse glucose events, understand glucose trends, and follow monitoring and insulin recommendations, while technology downsides lowered some caregivers' confidence.
03By the end of the study period, all adolescents were using CGMs, and all adolescents who reported decreased confidence were using insulin injections and had made no change in insulin delivery.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small qualitative study of 18 adolescents and 20 mothers, so it describes what these families reported rather than proving what works for all adolescents with type 1 diabetes. Most adolescents and mothers were non-Hispanic white, so the findings may not apply to racially and ethnically diverse families. Only the diabetes education comparator group was interviewed, so experiences may differ from families receiving the active cognitive behavioral intervention. Device use, routines, caregiver support, and education changed over time, so the contribution of CGMs or pumps alone cannot be separated from other influences. HbA1c did not change significantly over the study period, so perceived device benefits did not show up as measured glycemic improvement in this group.
Declared interests
The authors reported no financial conflicts of interest. The journal metadata lists NIH extramural research support, but the supplied text does not say the funder designed or wrote the study.
The easy way to misread this
Do not conclude that CGMs or insulin pumps improve diabetes control. Participants linked devices to greater confidence, but this was a qualitative study of families' reports, and the study did not observe a significant change in HbA1c over the study period.