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Original Research
Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets
Molly L. Tanenbaum, Sarah J. Hanes, Kellee M. Miller, Diana Naranjo, Rachel Bensen and Korey K. Hood
Diabetes Care 2016 Nov; dc161536. https://doi.org/10.2337/dc16-1536
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Abstract

OBJECTIVE Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these devices continues to be low. Some barriers to device uptake may be modifiable through psychosocial intervention, but little is known about which barriers and which patients to target.

RESEARCH DESIGN AND METHODS We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, diagnosis duration 20.4 [SD 12.5] years) to investigate barriers to device uptake, understand profiles of device users versus nonusers, and explore differences by age and sex. Scales used were the Diabetes Distress Scale, technology use attitudes (general and diabetes-specific), and barriers to device use and reasons for discontinuing devices.

RESULTS Most commonly endorsed modifiable barriers were related to the hassle of wearing devices (47%) and disliking devices on one’s body (35%). CGM users (37%) were older than nonusers (mean 38.3 vs. 33.5 years), had diabetes for longer (22.9 vs. 18.8 years), had more positive technology attitudes than older age-groups (22.6–26.0 vs. 21.4–24.8), and reported fewer barriers to using diabetes technology than nonusers (3.3 vs. 4.3). The youngest age-group (18–25 years) had the lowest CGM (26% vs. 40–48%) and insulin pump (64% vs. 69–77%) uptake, highest diabetes distress (2.2 vs. 1.8–2.1), and highest A1C levels (8.3% [67 mmol/mol] vs. 7.2–7.4% [55–57 mmol/mol]).

CONCLUSIONS Efforts to increase device use need to target physical barriers to wearing devices. Because young adults had the lowest device uptake rates, highest distress, and highest A1C compared with older age-groups, they should be the focus of future interventions to increase device use.

  • Received July 15, 2016.
  • Accepted November 3, 2016.
  • © 2016 by the American Diabetes Association and Springer-Verlag.
http://www.diabetesjournals.org/content/license

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

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Diabetes Care: 41 (4)

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April 2018
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Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets
Molly L. Tanenbaum, Sarah J. Hanes, Kellee M. Miller, Diana Naranjo, Rachel Bensen, Korey K. Hood
Diabetes Care Nov 2016, dc161536; DOI: 10.2337/dc16-1536

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Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets
Molly L. Tanenbaum, Sarah J. Hanes, Kellee M. Miller, Diana Naranjo, Rachel Bensen, Korey K. Hood
Diabetes Care Nov 2016, dc161536; DOI: 10.2337/dc16-1536
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© 2018 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.