Michael L. Ferm1, Daniel J. DeSalvo1, Chuan Zhou2, Miranda C. Bradford2, Faisal S. Malik2, Maeve B. O’Donnell2, Catherine Pihoker2, Abby R. Rosenberg3, Joyce P. Yi-Frazier2,3, Marisa E. Hilliard1
Behavioral Interventions and Glycemic Outcomes: Longitudinal CGM Analysis in Teens with Diabetes Distress in the PRISM-T1D Trial
- 2-site (Houston & Seattle), 1:1 RCT of PRISM vs. Usual Care
- Teens (13-18 yrs) with elevated diabetes distress
- Problem Areas in Diabetes – Teen screener score ≥30
- Analyzed subsample of CGM users (n = 104/172)
- Wilcoxon rank sum tests compared within-person CGM metrics between groups between baseline, 6, and 12 months
- Table 1 summarizes CGM user characteristics
- Table 2 & Figure 1 present within-person CGM metrics from baseline to 6 months and baseline to 12 months
- Time in range (TIR) declined by an average of 5.88% from baseline to 12 months in the usual care group compared to 1.23% in the PRISM group, while time in level 2 hyperglycemia increased by 4.93% in the usual care group and 0.06% in the PRISM group over the same period.
- No within-person differences reached statistical significance
1Baylor College of Medicine and Texas Children’s Hospital; Houston, TX
2Seattle Children’s Research Institute; Seattle, WA
3Dana-Farber Cancer Institute, Harvard Medical School; Boston, MA
Presenting Author: M.L. Ferm, MD - ferm@bcm.edu
Funding from NIDDK: 1R01DK121224, 3R01DK119246-03S1, 1K26DK138332
Clinically significant Time in Range difference after behavioral intervention in teens with diabetes distress
- The Promoting Resilience in Stress Management (PRISM) -T1D trial involved a brief, behavioral intervention to help teens with T1D and elevated diabetes distress develop resilience resources and skills
- In this exploratory analysis, less decline in TIR at a clinically significant level in the PRISM group suggests potential glycemic benefit from a resilience-building intervention
- Additional therapeutic components may be needed to enhance the impact of psychosocial intervention on glycemic metrics
- PRISM benefitted psychosocial outcomes, but not HbA1c
- Aim: Explore PRISM impact on CGM metrics, given greater glycemic specificity
Figure 1. Graphic representation of mean within-person difference in CGM ranges from baseline to 6 months (A) and baseline to 12 months (B). TAR, Time Above Range; TIR, Time In Range; TBR, Time Below Range; Glucose units: mg/dL.