Clinician, Youth, and Parent Perspectives on Diabetes Technology Education

The purpose of this study was to explore the educational experiences of youth with type 1 diabetes (T1D), their parents, and clinicians when initiating continuous glucose monitoring (CGM) and insulin pumps.

Twenty parent-child dyads with T1D ≥6 months and ≥1 month CGM and insulin pump use were eligible to participate in semistructured dyadic interviews. Purposive sampling was used to recruit youth with a range of A1C levels and to overrepresent dyads from minoritized backgrounds. Eight diabetes clinicians with ≥1 year of experience participated in individual interviews using a parallel interview guide. A subset of interviews was double-coded, and thematic analysis was used to generate themes.

Poor internet connections, distractions in the home, and small screens made in-person education the preferred modality for dyads and clinicians due to the physical skills required when learning to use these devices. Structured education addressing essential topics was constrained by allotted appointment times and thus (1) often overlooked cognitive and emotional burdens of diabetes technology education and (2) insufficiently accounted for individual learning pace and capacity. Real-world experiential learning supported by the clinical team through telemedicine, phone calls, and electronic medical record messaging was often used to fill the gaps of structured education.

Both clinicians and parent-child dyads initiating CGM and automated insulin delivery expressed a preference for in-person education. Although experiential learning can supplement important concepts not adequately addressed during structured education, relying solely on this approach may unintentionally omit crucial concepts. Educational strategies are needed to overcome information overload and support families in diabetes self-management.