Parental Perspectives and Clinical Outcomes across Insulin Delivery Methods for Pediatric Diabetes Management.

BACKGROUND

Pediatric diabetes management places substantial daily responsibility on caregivers and may contribute to diabetes-related distress. Advancing insulin technologies, including continuous glucose monitoring (CGM), mobile health applications, and automated insulin delivery (AID) systems, may reduce caregiver burden while improving glycemic outcomes.

OBJECTIVE

To examine associations between insulin delivery method (insulin pen, traditional insulin pump, or AID system) and caregiver distress, treatment satisfaction, and caregiver-reported clinical outcomes, including hemoglobin A1c (HbA1c) and time in range (TIR), among children with type 1 diabetes.

METHODS

A cross-sectional survey of parents/guardians of children aged 4-16 years with type 1 diabetes was conducted at a pediatric endocrinology practice in northern New Jersey. Caregiver distress and treatment satisfaction were measured using the PAID-PR and IDSS. Group differences were analyzed using ANOVA with Tukey post hoc tests, and associations with HbA1c and TIR were evaluated using chi-square tests.

RESULTS

Of 73 responses, 53 met inclusion criteria. Insulin delivery method was significantly associated with treatment satisfaction (p < .001), and caregiver distress (p = .004). AID users reported higher satisfaction, lower distress, and were more likely to achieve optimal HbA1c and TIR (p < .01).

CONCLUSIONS

AID systems were associated with improved glycemic outcomes and caregiver experiences. These findings support integrating advanced diabetes technologies into pediatric care while addressing access-related factors influencing technology use.

IMPLICATIONS TO PRACTICE: Automated insulin delivery systems may improve glycemic control and reduce caregiver distress. Healthcare providers should promote education, shared decision-making, and equitable access to diabetes technology.