Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes
Publication: Diabetes Technology & Therapeutics
Volume 25, Issue Number 9
Abstract
Background: Adolescents and young adults (AYA) from diverse and marginalized backgrounds with type 1 diabetes (T1D) generally have higher hemoglobin A1c (HbA1c) levels and less frequent continuous glucose monitor (CGM) use than AYA from more privileged backgrounds. Further, scant data address the impact of virtual peer groups (VPG) on health-related outcomes for ethnically and racially diverse AYA with T1D.
Methods: CoYoT1 to California was a 15-month randomized controlled trial for AYA aged 16–25 years. In this study, AYA were randomized to receive standard care (n = 28), or CoYoT1 care (n = 40), which consisted of person-centered provider visits and bimonthly VPG. VPG were AYA-driven discussions. AYA completed the Diabetes Distress Scale (DDS), Center for Epidemiologic Studies Depression (CES-D), and Diabetes Empowerment Scale-Short Form (DES-SF) scales at baseline and all study visits.
Results: Participants were 50% Latinx and 75% publicly insured. Among CoYoT1 care participants, 19 attended at least 1 VPG session (VPG attendees) and 21 did not attend any VPG sessions. VPG attendees participated in 4.1 VPG sessions on average. VPG attendees had a relative reduction in HbA1C (treatment effect −1.08%, effect sizes values [ES] = −0.49, P = 0.04) and increase in CGM use (treatment effect +47%, ES = 1.00, P = 0.02) compared to standard care. VPG participation was not associated with statistically significant changes in DDS, CES-D, and DES-SF scores.
Conclusions: In a 15-month randomized controlled trial, AYA with T1D who participated in VPG reported significant improvements in HbA1c and CGM use. Peer interactions may support unmet needs of AYA with T1D from diverse and marginalized backgrounds. ClinicalTrials.gov Identifier: NCT03793673.
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Information & Authors
Information
Published In
Diabetes Technology & Therapeutics
Volume 25 • Issue Number 9 • September 2023
Pages: 589 - 601
PubMed: 37335751
Copyright
Copyright 2023, Mary Ann Liebert, Inc., publishers.
History
Published in print: September 2023
Published online: 23 August 2023
Published ahead of print: 17 August 2023
Published ahead of production: 19 June 2023
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Authors
Authors' Contributions
D.I.B. conceived this analysis and prepared the initial article draft. M.W.R. designed and ran the statistical analyses. J.K.R. conceived, designed, and directed the underlying study. All authors contributed to results interpretation, discussion, and review/editing of the article.
Author Disclosure Statement
No competing financial interests exist.
Funding Information
This work was funded by The Patrick and Catherine Weldon Donaghue Medical Research Foundation.
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