789-P: Self-Care for Blood Glucose Monitoring (BGM) in Teens with Type 1 Diabetes (T1D): Impact of Real-Time Positive and Negative Affect

Abstract

Aim: Teens with T1D often report negative emotions related to diabetes self-care. Affect tends to vary throughout the day and may provide an explanatory pathway to poor diabetes self-care and suboptimal glycemic control in teens. We used momentary sampling to examine associations between affect and BGM adherence in teens with T1D. Methods: Over 2 weeks, 32 teens (ages 14-18 years) used handheld computers to self-report positive (POS) and negative (NEG) affect (Positive and Negative Affect Schedule) and BGM adherence 4 times daily. Teens selected the times to receive the messages based on their usual BGM times. There were 225 paired affect and BG adherence reports. Z-scores were calculated for the NEG and POS subscales to reflect deviations from each teen’s overall affect. Separate logistic generalized estimating equations, adjusted for age, sex, T1D duration, and pump therapy assessed associations between POS and NEG affect and BGM adherence. Results: Teens (56% female) were (M±SD) 16.6±1.4 years old with T1D duration of 8.8±4.2 years; 63% were pump treated and A1c was 8.8±1.4%. Teens reported checking BG 59% of the time. In adjusted models, greater NEG affect was associated with lower odds of BGM (OR=0.5, 95% CI: 0.4-0.8, p=.001). POS affect was not significantly associated with BGM. Age, sex, T1D duration, and pump therapy were not significantly associated with BGM. Conclusions: In a sample of teens with T1D receiving multiple daily prompts to check BG, positive affect did not relate to BGM frequency; however, negative affect was associated with being half as likely to check BG. These findings suggest a need to provide teens with strategies for maintaining diabetes self-care behaviors when they are experiencing negative emotions. Disclosure A. Shapira: None. L.K. Volkening: None. J. Borus: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US. Funding JDRF International; National Institutes of Health (P30DK036836, K12DK094721)