P-215: Diabetes technology shapes diabetes identity (di) among young adults (YAS) with type 1 diabetes (T1D): evidence from a grounded theory study
Y Mo, E Pyatak, J Agner, L McCainAbstract
Introduction
YAs with T1D experience uncertain transitions in healthcare and social contexts, creating challenges for incorporating diabetes into self-perception. DI incorporation is essential for psychosocial well-being and glycemic outcomes, and quantitative evidence points to device usage as an underexplored influence.
Objectives
To explore DI incorporation in YAs with T1D and examine how device experiences shape this process.
Methods
Twenty-six YAs with T1D were recruited via theoretical sampling from an RCT participant pool (Resilient, Empowered, Active Living with Diabetes - Telehealth, REAL-T). Semi-structured interviews were conducted and analyzed using constructive grounded theory, involving gerund initial coding followed by focused coding through constant comparison across transcripts by two researchers.
Results
Participants were predominantly female (61.5%), non-Hispanic white (65.5%), with private insurance (64.0%), and were users of continuous glucose monitoring (CGM) (92.3%) and insulin pumps (84.6%). Besides identified structural barriers of insurance and information access to device uptake, three device-identity themes emerged: (1) Device as enabler: CGM and insulin pumps reduced management burden, enabled flexible adjustment toindividual routines and physiology, facilitated T1D self-expression, and improved community engagement; (2) Device as burden: uncertainty in CGM number interpretation and reaction, pump alarm disruptions, and unrealistic target ranges added cognitive and emotional load, hindering DI incorporation; (3) Automated device concerns: trust calibration when delegating to automation, readiness for malfunctions, and trust disruption following device failures introduced new identity challenges.
Conclusions
Device experience among YAs with T1D should be understood as active human-technology interaction rather than passive reception. Future research and practice should target trust calibration, information-seeking, and agency in device-related decision-making to optimize DI incorporation.