Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026
Situational awareness predicts self-management of type I diabetes in adolescents and young adults.
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Cook Paul F, Jost Emily, Forlenza Gregory, Messer Laurel H, Thompson Solus, Peck Evan, Voida Stephen
Аннотация
OBJECTIVE: Using a hybrid closed-loop system predicts higher time in target glucose range (TIR) for adolescents and young adults with type I diabetes (T1D). However, patients do not always use these systems effectively for self-management. Based on Two Minds Theory, we hypothesized that more automatic and proactive ways of interacting with the system would be associated with higher TIR, whereas more reactive responses to system prompts would not.
METHOD: We recruited 20 patients with T1D from a diabetes clinic. Participants used the Tandem t:slim X2 with Control-IQ technology (Control-IQ) hybrid closed-loop system. For 2 weeks, they also completed daily surveys about T1D self-management, plus triggered surveys each time they interacted with Control-IQ about their reasons and perceived automaticity.
RESULTS: Proactive reasons for interacting with Control-IQ, such as planning to eat, predicted higher TIR. Reactive interactions, for example, responding to system alerts, did not. In fact, participants had higher TIR when they interacted less often with Control-IQ and administered fewer manual boluses. Self-reported automaticity did not predict TIR, but perceived self-management did. Suspecting high glucose was associated with higher TIR regardless of accuracy.
CONCLUSIONS: Adolescents who interacted less intensively and more proactively with a hybrid closed-loop system had better glucose control. Accurate perception of glucose mattered less than believing one's glucose might be too high; it is possible that situationally aware participants detected increases before their glucose went out of range. Better measures of automaticity are needed. Hybrid closed-loop systems help adolescents and young adults self-manage T1D when used in a situationally aware way. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
METHOD: We recruited 20 patients with T1D from a diabetes clinic. Participants used the Tandem t:slim X2 with Control-IQ technology (Control-IQ) hybrid closed-loop system. For 2 weeks, they also completed daily surveys about T1D self-management, plus triggered surveys each time they interacted with Control-IQ about their reasons and perceived automaticity.
RESULTS: Proactive reasons for interacting with Control-IQ, such as planning to eat, predicted higher TIR. Reactive interactions, for example, responding to system alerts, did not. In fact, participants had higher TIR when they interacted less often with Control-IQ and administered fewer manual boluses. Self-reported automaticity did not predict TIR, but perceived self-management did. Suspecting high glucose was associated with higher TIR regardless of accuracy.
CONCLUSIONS: Adolescents who interacted less intensively and more proactively with a hybrid closed-loop system had better glucose control. Accurate perception of glucose mattered less than believing one's glucose might be too high; it is possible that situationally aware participants detected increases before their glucose went out of range. Better measures of automaticity are needed. Hybrid closed-loop systems help adolescents and young adults self-manage T1D when used in a situationally aware way. (PsycInfo Database Record (c) 2026 APA, all rights reserved).