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Effect of an Automated Advice Algorithm (CloudConnect) on Adolescent-Parent Diabetes-Specific Communication and
Mark D DeBoer1,2, Rupa Valdez3,4, John P Corbett5
1Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA, 22908, USA. deboer@virginia.edu.
Summary
The CloudConnect decision support system did not improve Type 1 diabetes (T1D) communication or glycemic management in adolescents. While feasible, further research is needed for better T1D management strategies in this population.
Area of Science:
- Endocrinology
- Digital Health
- Adolescent Medicine
Background:
- Adolescence presents unique challenges for Type 1 diabetes (T1D) management due to shared responsibility between adolescents and parents.
- Effective communication and glycemic control are critical during this developmental stage.
Purpose of the Study:
- To evaluate the impact of the CloudConnect decision support system (DSS) on T1D-related communication between adolescents and parents.
- To assess the effects of CloudConnect on glycemic management in adolescents with T1D.
Main Methods:
- A 12-week study involving 86 participants (43 adolescents with T1D and their parents/caregivers) not using automated insulin delivery (AID) systems.
- Intervention groups received either Usual Care + Continuous Glucose Monitoring (CGM) or CloudConnect DSS, which provided automated T1D advice.
- Primary outcome: T1D-specific communication. Secondary outcomes: Hemoglobin A1c (HbA1c), time-in-target range (TIR), and psychosocial scales.
Main Results:
- No significant differences in T1D-related communication frequency or final HbA1c levels were observed between the CloudConnect and Usual Care groups.
- Glycemic control metrics, including TIR and time below range, did not differ between groups.
- Parents in the CloudConnect group reported less T1D-related conflict, but both adolescents and parents noted a more negative communication tone. More frequent insulin dose adjustments were reported in the CloudConnect group.
Conclusions:
- The CloudConnect DSS is feasible but did not enhance T1D communication or improve glycemic management in adolescents not on AID systems.
- Additional strategies are required to optimize T1D management for adolescents, particularly those not utilizing AID technology.
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