Self-Management Behaviors in Adults on Insulin Pump Therapy: What Are Patients Really Doing?

Danielle Groat, Maria Grando, Hiral Soni, Bithika Thompson, Mary Boyle, Marilyn Bailey, Curtiss B. Cook

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Background: Successful diabetes management requires behavioral changes. Little is known about self-management behaviors (SMB) in adults on insulin pump (IP) therapy. Objective: Analyze and characterize observed common diabetes SMB in adult participants with type 1 diabetes (T1D) using IPs and to correlate behaviors with glycemic outcomes based on participant's individual glucose targets. Materials and Methods: One month of IP data from adults with T1D were downloaded. Computer programs were written to automatically quantify the observed frequency of expected behaviors such as: insulin bolusing, checking blood glucose (BG), and recording carbohydrate intake, and other interactions with the IP. Results: Nineteen participants were recruited and 4,249 IP interactions were analyzed to ascertain behaviors. Intersubject variability of adherence to minimally expected behaviors was observed: daily documentation of carbohydrates and BG checks in 76.6 (31.7)% and 60.0 (32.5)%, respectively, and bolusing without consulting the IPBC in 13.0 (16.9)% of delivered boluses, while daily insulin bolus delivery was consistent 96.8 (5.7)%. Higher frequency of adherence to daily behaviors correlated with a higher number of glucose readings at target. Conclusion: Results indicate variability in SMB and do not always match recommendations. Case-scenarios based on observed real-life SMB could be incorporated into interviews/surveys to elucidate ways to improve SMB.

    Original languageEnglish (US)
    Pages (from-to)233-239
    Number of pages7
    JournalJournal of diabetes science and technology
    Volume11
    Issue number2
    DOIs
    StatePublished - Mar 1 2017

    Fingerprint

    Insulin
    Self Care
    Pumps
    Medical problems
    Glucose
    Carbohydrates
    Type 1 Diabetes Mellitus
    Blood Glucose
    Blood
    Therapeutics
    Documentation
    Computer program listings
    Reading
    Software
    Interviews

    Keywords

    • bolus calculator
    • insulin dosing
    • insulin pump
    • self-management behaviors
    • type 1 diabetes

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Bioengineering
    • Medicine(all)
    • Biomedical Engineering

    Cite this

    Self-Management Behaviors in Adults on Insulin Pump Therapy : What Are Patients Really Doing? / Groat, Danielle; Grando, Maria; Soni, Hiral; Thompson, Bithika; Boyle, Mary; Bailey, Marilyn; Cook, Curtiss B.

    In: Journal of diabetes science and technology, Vol. 11, No. 2, 01.03.2017, p. 233-239.

    Research output: Contribution to journalArticle

    Groat, Danielle ; Grando, Maria ; Soni, Hiral ; Thompson, Bithika ; Boyle, Mary ; Bailey, Marilyn ; Cook, Curtiss B. / Self-Management Behaviors in Adults on Insulin Pump Therapy : What Are Patients Really Doing?. In: Journal of diabetes science and technology. 2017 ; Vol. 11, No. 2. pp. 233-239.
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    abstract = "Background: Successful diabetes management requires behavioral changes. Little is known about self-management behaviors (SMB) in adults on insulin pump (IP) therapy. Objective: Analyze and characterize observed common diabetes SMB in adult participants with type 1 diabetes (T1D) using IPs and to correlate behaviors with glycemic outcomes based on participant's individual glucose targets. Materials and Methods: One month of IP data from adults with T1D were downloaded. Computer programs were written to automatically quantify the observed frequency of expected behaviors such as: insulin bolusing, checking blood glucose (BG), and recording carbohydrate intake, and other interactions with the IP. Results: Nineteen participants were recruited and 4,249 IP interactions were analyzed to ascertain behaviors. Intersubject variability of adherence to minimally expected behaviors was observed: daily documentation of carbohydrates and BG checks in 76.6 (31.7){\%} and 60.0 (32.5){\%}, respectively, and bolusing without consulting the IPBC in 13.0 (16.9){\%} of delivered boluses, while daily insulin bolus delivery was consistent 96.8 (5.7){\%}. Higher frequency of adherence to daily behaviors correlated with a higher number of glucose readings at target. Conclusion: Results indicate variability in SMB and do not always match recommendations. Case-scenarios based on observed real-life SMB could be incorporated into interviews/surveys to elucidate ways to improve SMB.",
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