The impact of continuous glucose monitoring on diabetes distress among high-risk adolescents and young adults: Secondary outcomes from a pilot randomized controlled trial

Adolescents and young adults (AYA) with Type 1 diabetes (T1D) are at an increased risk for health difficulties and diabetes distress. Continuous glucose monitoring (CGM) may decrease management burden and diabetes distress. The present study is a secondary analysis from a pilot randomized controlled trial that aims to evaluate the impact of CGM use with and without an added educational intervention on diabetes distress among a high-risk cohort of AYA with T1D. Of the 33 participants (M_age = 17.7; range 15-25 years) included in this secondary analysis, 19 were randomized to unblinded CGM with a pattern management intervention (CGM-PM) and 13 to CGM with treatment as usual (CGM-TAU), including 14 adults (≥18 years) and 19 parent/teen dyads. Adolescent participants and parents of adolescents completed the Problem Areas In Diabetes measure at baseline, 12, and 24 weeks. Multilevel modeling analyses were used to examine group differences in diabetes distress over time. At baseline, groups were similar in terms of demographics (e.g. race, age), hemoglobin A1c, and diabetes distress. In the unconditional models, diabetes distress decreased from baseline to 24 weeks for teenagers (<i>b</i> = -6.28, <i>SE</i> = 2.44, <i>p</i> = 0.013) and parents (<i>b</i> = -9.62, <i>SE</i> = 3.02, <i>p</i> = 0.004). However, diabetes distress did not significantly decrease at 12 weeks or 24 weeks for young adults (<i>p</i> = .050-.079). Three linear mixed models revealed no significant Time × Intervention effects for teenager, parent, or adult distress at 12 or 24 weeks. Results suggest that among a high-risk cohort, CGM technology supports reductions in diabetes distress for parents and teenagers, but not young adults. Future research should examine individual and systemic barriers that impede improvements in distress in young adults.