Introduction and Objective: Adolescents with type 1 diabetes (T1D) have elevated glycemic levels, partially due to inconsistent continuous glucose monitor (CGM) use. We examined if peer mentorship tailored to youth with T1D at high risk for adverse health outcomes could positively impact CGM wear time and glycemic levels. Methods: Adolescent-caregiver dyads (n=21; MYouthAge=14.5 years; 50% Black; MA1c=9.6%) were randomized (1:1) to Usual Care or Type 1 Together, where families met with a peer mentor family and community health worker and accessed educational resources. Dyads self-reported demographics. CGM wear time and HbA1c data were collected at baseline and 6-months post-randomization via device portals (CGM wear time) and home kits or clinic visits (HbA1c). Four teens (2 in Type 1 Together; 2 in Usual Care) had missing 6-month HbA1c or CGM data, which was handled via last-observation carried forward. A 2x2 factorial ANOVA examined effects of group (Type 1 Together vs Usual Care) and time (baseline vs 6 months) on outcomes. Effect sizes and p-values were examined. Results: At baseline, most youth wore CGM 80% (Type 1 Together = 55%, Usual Care = 60%) and had a HbA1c 9% (Type 1 Together = 82%, Usual Care = 50%). There was no effect of group on CGM wear time at 6 months (p = .98; η2p = 0.001). However, at 6-months post-randomization, the average wear time of youth in Type 1 Together with inconsistent CGM use at baseline was 76% while the average wear time for youth in Usual Care was 48%. Given the small sample size, this effect was not statistically significant (F 1, 10 = 1.83, p = .21, η2p = 0.16). Youth in Type 1 Together experienced greater reductions in HbA1c (MBaseline = 9.7%; M6month = 8.7%) vs. Usual Care (MBaseline = 9.4%; M6month = 9.6%) (F 1, 19 = 5.66, p = .04; η2p = 0.21). Conclusion: Preliminary results suggest that peer mentorship may improve CGM wear time and HbA1c among youth with T1D at risk for poor health outcomes. Promising results support the need for a larger clinical trial testing the efficacy of Type 1 Together. Disclosure P. Enlow: None. C. Thomas: None. C. Yang: None. G. Vega: None. A. Decino: None. M.A. Alderfer: None. Funding National Institutes of Health (P20GM144270)
Enlow et al. (Fri,) studied this question.