Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes

Daniel I. Bisno; Mark W. Reid; Elizabeth A. Pyatak; Jaquelin Flores Garcia; Elizabeth Salcedo-Rodriguez; Alejandra Torres Sanchez; D. Steven Fox; Sarah Hiyari; Jennifer L. Fogel; Ian Marshall; Gloria Bachmann; Jennifer K. Raymond

doi:https://doi.org/10.1089/dia.2023.0199

Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes

Daniel I. Bisno, Mark W. Reid, Elizabeth A. Pyatak, Jaquelin Flores Garcia, Elizabeth Salcedo-Rodriguez, Alejandra Torres Sanchez, D. Steven Fox, Sarah Hiyari, Jennifer L. Fogel, Ian Marshall, Gloria Bachmann, Jennifer K. Raymond

Robert Wood Johnson Medical School (RWJMS), Obstetrics, Gynecology and Reproductive Sciences

Rutgers, The State University

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Journal	Diabetes Technology and Therapeutics
DOIs	https://doi.org/10.1089/dia.2023.0199
State	Accepted/In press - 2023

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Endocrinology
Medical Laboratory Technology

Keywords

Telehealth
Type 1 diabetes
Virtual peer groups
Young adults

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https://doi.org/10.1089/dia.2023.0199

Cite this

Bisno, D. I., Reid, M. W., Pyatak, E. A., Flores Garcia, J., Salcedo-Rodriguez, E., Torres Sanchez, A., Fox, D. S., Hiyari, S., Fogel, J. L., Marshall, I., Bachmann, G., & Raymond, J. K. (Accepted/In press). Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes. Diabetes Technology and Therapeutics. https://doi.org/10.1089/dia.2023.0199

@article{1b292e9ee918444ab87176f164cee7f5,

title = "Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes",

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.",

keywords = "Telehealth, Type 1 diabetes, Virtual peer groups, Young adults",

author = "Bisno, {Daniel I.} and Reid, {Mark W.} and Pyatak, {Elizabeth A.} and {Flores Garcia}, Jaquelin and Elizabeth Salcedo-Rodriguez and {Torres Sanchez}, Alejandra and Fox, {D. Steven} and Sarah Hiyari and Fogel, {Jennifer L.} and Ian Marshall and Gloria Bachmann and Raymond, {Jennifer K.}",

year = "2023",

doi = "https://doi.org/10.1089/dia.2023.0199",

language = "English (US)",

journal = "Diabetes Technology and Therapeutics",

issn = "1520-9156",

publisher = "Mary Ann Liebert Inc.",

}

Bisno, DI, Reid, MW, Pyatak, EA, Flores Garcia, J, Salcedo-Rodriguez, E, Torres Sanchez, A, Fox, DS, Hiyari, S, Fogel, JL, Marshall, I , Bachmann, G & Raymond, JK 2023, 'Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes', Diabetes Technology and Therapeutics. https://doi.org/10.1089/dia.2023.0199

TY - JOUR

T1 - Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes

AU - Bisno, Daniel I.

AU - Reid, Mark W.

AU - Pyatak, Elizabeth A.

AU - Flores Garcia, Jaquelin

AU - Salcedo-Rodriguez, Elizabeth

AU - Torres Sanchez, Alejandra

AU - Fox, D. Steven

AU - Hiyari, Sarah

AU - Fogel, Jennifer L.

AU - Marshall, Ian

AU - Bachmann, Gloria

AU - Raymond, Jennifer K.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Telehealth

KW - Type 1 diabetes

KW - Virtual peer groups

KW - Young adults

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U2 - https://doi.org/10.1089/dia.2023.0199

DO - https://doi.org/10.1089/dia.2023.0199

M3 - Article

C2 - 37335751

SN - 1520-9156

JO - Diabetes Technology and Therapeutics

JF - Diabetes Technology and Therapeutics

ER -

Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes

Abstract

ASJC Scopus subject areas

Keywords

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