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Cited by 296Diabetes Management and ResearchDiabetes Management and EducationDiabetes and associated disorders

Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets

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Tanenbaum, Molly L., Hanes, Sarah J., Miller, Kellee M., Naranjo, Diana, Bensen, Rachel, Hood, Korey K.·2017·Diabetes Care
DOI 10.2337/dc16-1536PMC PMC5864141
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Abstract

OBJECTIVE Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these devices continues to be low. Some barriers to device uptake may be modifiable through psychosocial intervention, but little is known about which barriers and which patients to target. RESEARCH DESIGN AND METHODS We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, mean diagnosis duration 20.4 [SD 12.5] years) to investigate barriers to device uptake, understand profiles of device users versus nonusers, and explore differences by age and sex. Scales used were the Diabetes Distress Scale, Technology Use Attitudes (General and Diabetes-Specific), and Barriers to Device Use and Reasons for Discontinuing Devices. RESULTS Most commonly endorsed modifiable barriers were related to the hassle of wearing devices (47%) and disliking devices on one’s body (35%). CGM users (37%) were older than nonusers (mean 38.3 vs. 33.5 years), had diabetes for longer (22.9 vs. 18.8 years), had more positive technology attitudes (22.6–26.0 vs. 21.4–24.8), and reported fewer barriers to using diabetes technology than nonusers (3.3 vs. 4.3). The youngest age-group (18–25 years) had the lowest CGM (26% vs. 40–48%) and insulin pump (64% vs. 69–77%) uptake, highest diabetes distress (2.2 vs. 1.8–2.1), and highest HbA1c levels (8.3% [67 mmol/mol] vs. 7.2–7.4% [55–57 mmol/mol]). CONCLUSIONS Efforts to increase device use need to target physical barriers to wearing devices. Because young adults had the lowest device uptake rates, highest distress, and highest HbA1c compared with older age-groups, they should be the focus of future interventions to increase device use.

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  • The cost of insulin pumps and supplies are the most commonly reported barrier by patients against initiation of insulin pump therapy.

    “The cost of insulin pumps and supplies are the most commonly reported barrier by patients against initiation of insulin pump therapy,29”

    From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [29]

    The Results (Aim 1; page unavailable) identify cost of supplies (61%) and cost of device (57%) as the most commonly reported barriers to using diabetes devices. Those figures cover devices generally, not specifically initiation of insulin pump therapy. The paper separately reports that among people who stopped using pumps, discomfort and dislike of wearing a device were more common reasons than cost. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Tanenbaum, M. L., Hanes, S. J., Miller, K. M., Naranjo, D., Bensen, R., & Hood, K. K.
Affiliations
  • Stanford Medicine (US)
  • Jaeb Center for Health Research (US)
Corresponding author
Hood, Korey K.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2016-11-29
Volume
40
Issue
2
Pages
181-187
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc16-1536
PMC
PMC5864141
OpenAlex
W2558617381
Cited by
296
References
2
Citations by year
2026: 19 · 2025: 33 · 2024: 31 · 2023: 40 · 2022: 26 · 2021: 45 · 2020: 40 · 2019: 33 · 2018: 18 · 2017: 10
FWCI
20.44
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor, 52 d)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Leona M. and Harry B. Helmsley Charitable Trust
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords
type 1 diabetes, diabetes technology adoption, insulin pump, continuous glucose monitors, diabetes distress, attitudes toward technology, young adults, glycemic control, HbA1c, psychosocial interventions, sex differences
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Insulin Infusion Systems, Male, Middle Aged, Surveys and Questionnaires, Blood Glucose Self-Monitoring, Young Adult

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