Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes

Background: Diabetes technologies, such as insulin pumps and continuous glucose monitors (CGM), have been associated with improved glycemic control and increased quality of life for young people with type 1 diabetes (T1D); however, few young people use these devices, especially those from minority ethnic groups. Current literature predominantly focuses on white patients with private insurance and does not report experiences of diverse pediatric patients with limited resources. Methods: To explore potential differences between Latinx and non-Latinx patients, English- and Spanish-speaking young people with T1D ( n = 173, ages 11-25 years) were surveyed to assess attitudes about and barriers to diabetes technologies using the Technology Use Attitudes and Barriers to Device Use questionnaires. Results: Both English- and Spanish-speaking participants who identified as Latinx were more likely to have public insurance ( P = .0001). English-speaking Latinx participants reported higher Hemoglobin A1c values ( P = .003), less CGM use ( P = .002), and more negative attitudes about technology (generally, P = .003; and diabetes-specific, P < .001) than either non-Latinx or Spanish-speaking Latinx participants. Barriers were encountered with equivalent frequency across groups. Conclusions: Latinx English-speaking participants had less positive attitudes toward general and diabetes technology than Latinx Spanish-speaking and non-Latinx English-speaking peers, and differences in CGM use were associated with socioeconomic status. Additional work is needed to design and deliver diabetes interventions that are of interest to and supportive of patients from diverse ethnic and language backgrounds.

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What young people want from their diabetes team: developing a patient reported experience measure (PREM) for young people with type 1 diabetes

Practical Diabetes ◽

10.1002/pdi.1941 ◽

2015 ◽

Vol 32 (4) ◽

pp. 142-147a ◽

Cited By ~ 6

Author(s):

Isabella Girling ◽

Emma Day ◽

Kate Fazakerley ◽

Tat Gray ◽

Peter Hindmarsh ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young People ◽

Patient Reported ◽

Experience Measure

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Quality of life in chronic conditions using patient-reported measures and biomarkers: a DEA analysis in type 1 diabetes

Health Economics Review ◽

10.1186/s13561-019-0248-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Sixten Borg ◽

Ulf-G. Gerdtham ◽

Katarina Eeg-Olofsson ◽

Bo Palaszewski ◽

Soffia Gudbjörnsdottir

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Type 1 Diabetes ◽

Patient Reported Outcomes ◽

Efficiency Analysis ◽

Outcomes Measures ◽

Patient Reported ◽

The Individual

Abstract Background A chronic disease impacts a patient’s daily life, with the burden of symptoms and managing the condition, and concerns of progression and disease complications. Such aspects are captured by Patient-Reported Outcomes Measures (PROM), assessments of e.g. wellbeing. Patient-Reported Experience Measures (PREM) assess patients’ experiences of healthcare and address patient preferences. Biomarkers are useful for monitoring disease activity and treatment effect and determining risks of progression and complications, and they provide information on current and future health. Individuals may differ in which among these aspects they consider important. We aimed to develop a measure of quality of life using biomarkers, PROM and PREM, that would provide an unambiguous ranking of individuals, without presuming any specific set of importance weights. We anticipated it would be useful for studying needs and room for improvement, estimating the effects of interventions and comparing alternatives, and for developing healthcare with a broad focus on the individual. We wished to examine if efficiency analysis could be used for this purpose, in an application to individuals with type 1 diabetes. Results We used PROM and PREM data linked to registry data on risk factors, in a large sample selected from the National Diabetes Registry in Sweden. Efficiency analysis appears useful for evaluating the situation of individuals with type 1 diabetes. Quality of life was estimated as efficiency, which differed by age. The contribution of different components to quality of life was heterogeneous, and differed by gender, age and duration of diabetes. Observed quality of life shortfall was mainly due to inefficiency, and to some extent due to the level of available inputs. Conclusions The efficiency analysis approach can use patient-reported outcomes measures, patient-reported experience measures and comorbidity risk factors to estimate quality of life with a broad focus on the individual, in individuals with type 1 diabetes. The approach enables ranking and comparisons using all these aspects in parallel, and allows each individual to express their own view of which aspects are important to them. The approach can be used for policy regarding interventions on inefficiency as well as healthcare resource allocation, although currently limited to type 1 diabetes.

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