Background: Diabetes technologies are valuable tools to reduce burden and enhance glycemic control, especially during adolescence. The current study sought to understand the factors associated with parent and adolescent diabetes device satisfaction.
Methods: This study used cross-sectional data from 175 adolescents living with type 1 diabetes and 176 parents. Adolescent ages ranged from 12 to 19 (Mage=14.7, SD=1.89) and were balanced by gender (48% male). Kendall's W examined concordance between parent and adolescent satisfaction and bivariate correlations and paired t-tests identified correlates of satisfaction.
Results: There was low concordance (Kendall's W = 0.13) between parent and adolescent device satisfaction. Automated insulin delivery (AID) use (vs non-use) was related to higher satisfaction for adolescents (4.52 [0.71] vs 4.20 [0.87], P = .008) and parents (4.25 [0.82] vs 3.71 [0.90], P < .001). Pump use was not significantly related. Parent satisfaction was correlated with hemoglobin A1c (HbA1c; R = -0.301, P < .001), percent time-in-range (R = 0.214, P = .007), and percent time-above-range (R = -0.193, P = .015). Adolescent satisfaction was unrelated to glycemic measures. Adolescent and parent satisfaction were both related to better psychosocial functioning. Significant associations between AID use, psychosocial functioning, and glycemic control and device satisfaction remained after accounting for one another. Demographic correlates were non-significant.
Conclusions: Adolescents and their parents have discrepant levels of satisfaction with devices. Although both adolescent and parent satisfaction are linked to use of automated technology and better psychosocial functioning, only parent satisfaction is associated with glycemia. This pattern suggests adolescents and parents hold varying priorities when it comes to device use. Acknowledging and addressing these differences may enhance the uptake and continued use of devices.
Keywords: adolescents; diabetes management; diabetes technology; type 1 diabetes.