Work

SAT-589 Assessing Provider Perspectives in Delivering Diabetes Self Management (DSMES) and Transfer of Care in Emerging Adults (EAs) with Type 1 Diabetes (T1D): A Human Centered Design Approach

Year: 2025

Type: article

Abstract: Disclosure: J.M. Ng: None. M. Hamm: None. L. Funair: None. F. Cameron: None. J. Krall: None. L.M. Siminerio: None. I. Libman: None. Introduction and Objectives: T1D is a chronic condition and data has shown that glycemia via HbA1c levels can increase over time in EAs as they take progressive responsibility in all aspects of their lives. It is crucial that effective DSMES and transfer from pediatric to adult diabetes care for T1D EAs is optimized, as barriers can result in sub-optimal glycemia and increased complication rates. Our objective was to identify any barriers that may exist from provider perspectives. Methods: We conducted semi-structured interviews with diabetes providers treating EAs (n= 10 pediatric and 10 adult), and then engaged them in a design sprint, an intervention co-design process grounded in human centered design. Interviews were transcribed and coded using an inductively developed codebook; content and thematic analyses are ongoing. Design sprint sessions were summarized by a qualitative methodologist. Results: Interview participants described challenges related to DSMES in this age group, and barriers to optimal transfers of care from pediatric to adult diabetes care. Barriers to effective education included: too few available diabetes educators; scheduling difficulties due to business at this life stage; education inattentiveness in the teen years; and difficulty managing new diabetes technologies. Barriers to transfer included: strong patient-provider relationships on the pediatric side and patient (and provider) reluctance to leave those relationships; fear of the unknown and taking on one’s own care; and insurance and other financial concerns. Design sprint participants echoed these findings but also raised concerns that transfer to adult care and diabetes self-management as an adult started too late (i.e., when patients left home for the first time for work or secondary education) leaving patients and parents feeling overwhelmed. They advocated preparation for transfers to occur slowly, in age-appropriate ways, beginning as young as 12-13 years old, and for these transfers to be scaffolded and supported by online, asynchronous support delivered through short videos and modules similar to YouTube videos. Conclusions:: Our findings identify barriers that exist in both DSMES and transfer of care from pediatric to adult diabetes care in EAs with T1D. Designing optimal delivery methods for DSMES and transfer of care from pediatric to adult care using these observations may optimize glycemia and overall outcomes for EAs with T1D. Presentation: Saturday, July 12, 2025

Source: Journal of the Endocrine Society

DOI: 10.1210/jendso/bvaf149.1118