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Article
Motivational Stage at Continuous Glucose Monitoring (CGM) Initiation in Pediatric Type 1 Diabetes Is Associated With Current Glycemic Control but Does Not Predict Future CGM Adherence or Glycemic Control
Canadian Journal of Diabetes
  • Kate C. Verbeeten, Children's Hospital of Eastern Ontario, Ottawa
  • Jason Chan, Children's Hospital of Eastern Ontario, Ottawa
  • Nadia Sourial, Children's Hospital of Eastern Ontario, Ottawa
  • Jennilea M. Courtney, Children's Hospital of Eastern Ontario, Ottawa
  • Brenda J. Bradley, Children's Hospital of Eastern Ontario, Ottawa
  • Karen McAssey, McMaster Children's Hospital
  • Cheril Clarson, London Health Sciences Centre
  • Susan Kirsch, Markham Stouffville Hospital
  • Jacqueline R. Curtis, Hospital for Sick Children University of Toronto
  • Farid H. Mahmud, Hospital for Sick Children University of Toronto
  • Tammy Cooper, Children's Hospital of Eastern Ontario, Ottawa
  • Christine Richardson, Children's Hospital of Eastern Ontario, Ottawa
  • Margaret L. Lawson, Children's Hospital of Eastern Ontario, Ottawa
Document Type
Article
Publication Date
7-1-2021
URL with Digital Object Identifier
10.1016/j.jcjd.2021.04.004
Abstract

Objectives: The Timing of Initiation of Continuous Glucose Monitoring in Established Pediatric Diabetes (CGM TIME) Trial is a multicenter, randomized controlled trial in children with type 1 diabetes, comparing simultaneous pump and CGM with CGM initiation 6 months later (Paradigm, Veo, Enlite Sensor, Medtronic Canada). This study addresses the ability of SOCRATES (Stages Of Change Readiness And Treatment Eagerness Scale) to classify children and parents into distinct motivational stages and identify the stages’ association with glycated hemoglobin (A1C) at trial entry and outcomes 6 months after CGM initiation. Methods: Ninety-eight of 99 eligible children 10 to 18 years of age and 137 of 141 eligible parents completed SOCRATES at trial entry and 6 months later. Parent-child agreement for motivational stage was determined by weighted kappa. Linear regression was used to examine association between motivational stage and i) A1C at trial entry and ii) change in A1C and CGM adherence 6 months after CGM initiation. Results: More than 87% of children and 88% of parents were classified into distinct motivational stages, with weak parent-child agreement. At trial entry, motivational stage was associated with A1C, which was 1.02% higher for children in the Action stage than in the Precontemplation stage (p<0.0001). When compared with children of parents in Precontemplation, A1C for children of parents in the Maintenance and Action stages were 0.83% (p=0.02) and 0.36% (p=0.048) higher, respectively. Precontemplation was associated with shorter diabetes duration. Motivational stage at CGM initiation did not predict change in A1C or CGM adherence 6 months later. Conclusions: SOCRATES can categorize children with type 1 diabetes and their parents into motivational stages. Although motivational stage was associated with glycemic control at trial entry, it did not predict future diabetes-related behaviour or A1C.

Citation Information
Kate C. Verbeeten, Jason Chan, Nadia Sourial, Jennilea M. Courtney, et al.. "Motivational Stage at Continuous Glucose Monitoring (CGM) Initiation in Pediatric Type 1 Diabetes Is Associated With Current Glycemic Control but Does Not Predict Future CGM Adherence or Glycemic Control" Canadian Journal of Diabetes Vol. 45 Iss. 5 (2021) p. 466 - 472.e4
Available at: http://works.bepress.com/cheril-clarson/14/