‘We're taught green is good’: Perspectives on time in range and time in tight range from youth with type 1 diabetes, and parents of youth with type 1 diabetes

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Molly L. Tanenbaum, Erica Pang, Rachel Tam, Franziska K. Bishop, Priya Prahalad, Dessi P. Zaharieva, Ananta Addala, Jessie J. Wong, Diana Naranjo, Korey K. Hood, David M. Maahs
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引用次数: 0

Abstract

Aims

Continuous glucose monitoring (CGM) systems are standard of care for youth with type 1 diabetes with the goal of spending >70% time in range (TIR; 70–180 mg/dL, 3.9–10 mmol/L). We aimed to understand paediatric CGM user experiences with TIR metrics considering recent discussion of shifting to time in tight range (TITR; >50% time between 70 and 140 mg/dL, 3.9 and 7.8 mmol/L).

Methods

Semi-structured interviews and focus groups with adolescents with type 1 diabetes and parents of youth with type 1 diabetes focused on experiences with TIR goals and reactions to TITR. Groups and interviews were audio-recorded, transcribed and analysed using content analysis.

Results

Thirty participants (N = 19 parents: age 43.6 ± 5.3 years, 79% female, 47% non-Hispanic White, 20 ± 5 months since child's diagnosis; N = 11 adolescents: age 15.3 ± 2 years, 55% female, 55% non-Hispanic White, 16 ± 3 months since diagnosis) attended. Participants had varying levels of understanding of TIR. Some developed personally preferred glucose ranges. Parents often aimed to surpass 70% TIR. Many described feelings of stress and disappointment when they did not meet a TIR goal. Concerns about TITR included increased stress and burden; risk of hypoglycaemia; and family conflict. Some participants said TITR would not change their daily lives; others said it would improve their diabetes management. Families requested care team support and a clear scientific rationale for TITR.

Conclusions

The wealth of CGM data creates frequent opportunities for assessing diabetes management and carries implications for management burden. Input from people with type 1 diabetes and their families will be critical in considering a shift in glycaemic goals and targets.

我们接受的教育是'绿色是好的':1 型糖尿病青少年患者和 1 型糖尿病青少年患者父母对范围内时间和狭小范围内时间的看法。
目的:连续葡萄糖监测(CGM)系统是 1 型糖尿病患者的标准治疗方法,其目标是 70% 以上的时间在范围内(TIR;70-180 mg/dL,3.9-10 mmol/L)。考虑到最近关于转向时间在严格范围内(TITR;>50% 的时间在 70-140 毫克/分升,3.9-7.8 毫摩尔/升之间)的讨论,我们旨在了解儿科 CGM 用户对 TIR 指标的体验:方法:对 1 型糖尿病青少年和 1 型糖尿病青少年的父母进行半结构式访谈和焦点小组讨论,重点讨论 TIR 目标的经验和对 TITR 的反应。对小组和访谈进行了录音、转录并使用内容分析法进行了分析:30 名参与者(N = 19 名家长:年龄 43.6 ± 5.3 岁,79% 为女性,47% 为非西班牙裔白人,孩子确诊后 20 ± 5 个月;N = 11 名青少年:年龄 15.3 ± 2 岁,55% 为女性,55% 为非西班牙裔白人,孩子确诊后 16 ± 3 个月)参加了此次活动。参与者对 TIR 的理解程度各不相同。有些人制定了个人偏好的血糖范围。家长通常以超过 70% 的 TIR 为目标。许多人描述了当他们没有达到 TIR 目标时的压力感和失望感。对 TITR 的担忧包括增加压力和负担、低血糖风险和家庭冲突。一些参与者表示 TITR 不会改变他们的日常生活;另一些人则表示 TITR 会改善他们的糖尿病管理。家人要求护理团队提供支持,并为 TITR 提供明确的科学依据:丰富的 CGM 数据为评估糖尿病管理创造了频繁的机会,并对管理负担产生了影响。在考虑改变血糖目标和指标时,1 型糖尿病患者及其家属的意见至关重要。
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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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