P-155: Is the optimal treatment always the right one? parental considerations when choosing diabetes technologies in type 1 diabetes
M A Campbell, D GrabowskiAbstract
Introduction
International guidelines (ISPAD 2024) recommend the combined use of continuous glucose monitoring (CGM) and insulin pump therapy for optimal glycaemic control in children and adolescents with type 1 diabetes (T1D). Research on diabetes technology use in this population has largely focused on factors considered by healthcare providers (HCPs), such as glycaemic outcomes or patient readiness, but less is known about the parents’ considerations when determining which device options are right for their child and family in practice.
Objectives
To explore how parents navigate between optimal treatment options and what is right for their child and family in practice.
Methods
As part of a larger qualitative study, in-depth interviews and observations were conducted with 33 parents (22 fathers, 11 mothers) of children/adolescents with T1D in Greece and Denmark (2023-2024). Data was collected on why parents chose to adopt, delay, or decline available technologies.
Results
Optimal care was determined by clinical guidelines and technologies offered by local healthcare systems, but parents considered practical and social factors in determining which options were right for their child. Across settings, these included publicly-subsidised device replacement policies, parents’ own capacity to manage devices—including time, energy, and technological competence–and compatibility with the child’s social and recreational activities. Fathers were more likely to embrace new and more complicated systems. Parents in Denmark were more likely to consider technologies that encouraged their child’s independence, while mothers in Greece tended to delay transferring management tasks to the child, reflecting the influence of differing parenting norms on treatment choice across settings.
Conclusions
These findings highlight the importance for HCPs to consider sociocultural parenting norms and values, as well as differences between mothers’ and fathers’ roles and perspectives, when discussing technology options with families.