O-36: Participation and effectiveness of a novel diabetes self-management education and support (DSMES) program for emerging adults (EAs) with type 1 diabetes (T1D): the treat-ed study
I Libman, J Krall, K Ruppert, A Patel, E Hileman-Kaplan, C Moon, M Hamm, J Ng, L SiminerioAbstract
Introduction
EAs with T1D have unique challenges regarding diabetes self-management. They also have alarmingly low rates of DSMES participation.
Objectives
This pilot study assessed participation and effectiveness of a novel approach to DSMES (TREAT-ED) that incorporates technological and applied learning-driven methods through group telemedicine visits to improve EAs DSMES engagement.
Methods
EAs with T1D (18-26y) were recruited from pediatric and adult diabetes clinics (49 enrolled; 3 removed/withdrew). DSMES included 4 virtual, group-based sessions, 30-45 minutes long, led by a diabetes care and education specialist (DCES). Sessions centered on self-care behaviors within the context of issues salient to EAs, using case studies and CGM downloads, engage EAs in discussions, and encourage self-application of knowledge/skills gained. We evaluated hemoglobin A1c (HbA1c) and patient related outcomes including distress, empowerment, self-efficacy for self-management (SEDM) and readiness for transition (assessed by TRAQ) pre and 6 months post participation.
Results
Participants were 56% female, 90% White, mean age 21.7±2.2y, median T1D duration 11y (IQR: 6-16y), 91% with CGM use, 78% on insulin pumps, mean baseline HbA1c 7.1±1.2%. Most (76%) attended 3 of 4 DSMES sessions, with 65% attending all 4. From baseline to follow-up, HbA1c improved (-0.3%, p= 0.02). After adjusting for age, T1D duration, baseline body mass index, pump and CGM use, attending 2 sessions remained associated with improvement in HbA1c (p=0.03), and SEDM (p=0.005). Attending 3 sessions was significantly associated with transition readiness (p=0.008). There were no significant differences in distress or empowerment pre to post participation.
Conclusions
This novel virtual DSMES program for EAs with T1D engaged participants and resulted in meaningful improvement in glycemic outcome, SEDM, and transition readiness. These findings are encouraging and warrant further investigation in the pursuit of finding evidence-based ways to support EAs with T1D.