Young adults face many pressures as they start being independent and responsible for their own actions and decisions. The use of continuous glucose monitoring has been shown to improve medical outcomes in diabetes management, but the mechanism of these improvements needs further investigation. This study aimed to examine the self-regulatory experiences and behaviours of a group of young adults using continuous glucose monitoring to manage type 1 diabetes. An exploratory qualitative approach was taken, using six virtual semi-structured interviews with young adults living with type 1 diabetes and using continuous glucose monitoring. A thematic analysis was used to identify themes from the gathered data. In this study, three themes demonstrated reciprocal determinism in that the observation of the continuous glucose monitoring results led to changes in the behaviours of the participants. The concepts of feedback and feedforward were also evident in the information provided by continuous glucose monitoring and the adjustment of the participants to achieve their personal blood glucose goals. The results of this study thus support the fact that self-regulation of those living with type 1 diabetes can be improved using continuous glucose monitoring as a tool for observation of blood glucose fluctuations and can, as a result, lead to changes in diabetes management behaviours and health outcomes. Continuous glucose monitoring provides the opportunity to observe the consequences of diabetes management behaviours, which activates the self-regulation processes of feedback and feedforward. This process has the potential to improve diabetes management behaviours in this vulnerable group.
AbdoliS.HesslerD.SmitherB.Miller-BainsK.BurrE. M.StuckeyH. L. (2020). New insights into diabetes burnout and its distinction from diabetes distress and depressive symptoms: A qualitative study. Diabetes Research and Clinical Practice, 169, 108446. https://doi.org/10.1016/j.diabres.2020.108446
2.
AliO. (2017). Type 1 diabetes mellitus: Epidemiology, genetics, pathogenesis, and clinical manifestations. In PoretskyL. (Ed.), Principles of diabetes mellitus (3rd ed., pp. 241–265). Springer.
3.
BanduraA. (1977a). Antecedent determinants. In BanduraA. (Ed.), Social learning theory (pp. 56–93). Prentice-Hall.
4.
BanduraA. (1977b). Consequent determinants. In BanduraA. (Ed.), Social learning theory (pp. 94–158). Prentice-Hall.
5.
BanduraA. (1977c). Origins of behavior. In BanduraA. (Ed.), Social learning theory (pp. 14–55). Prentice-Hall.
6.
BanduraA. (1977d). Reciprocal determinism. In BanduraA. (Ed.), Social learning theory (pp. 192–213). Prentice-Hall.
7.
BergenstalR. M.NimriR.BeckR. W.CriegoA.LaffelL.SchatzD., . . . FLAIR Study Group. (2021). A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes (FLAIR): A multicentre, randomised, crossover trial. Lancet, 397, 208–219.
8.
BoyceE. (2020). Knowledge is power? How continuous blood glucose monitoring systems are changing the management of type 1 diabetes mellitus. Pediatric Nursing, 46(4), 179–183.
BronnerM. B.PeetersM. A. C.SattoeJ. N. T.van StaaA. (2020). The impact of type 1 diabetes on young adults’ health-related quality of life. Health and Quality of Life Outcomes, 18(1), 137. https://doi.org/10.1186/s12955-020-01370-8
11.
BurrV. (2015). What is social constructionism? In BurrV. (Ed.), Social constructionism (3rd ed., pp. 1–30). Routledge.
12.
CaiL.GeW.ZhuZ.ZhaoX.LiZ. (2019). Data analysis and accuracy evaluation of a continuous glucose-monitoring device. Journal of Sensors, 2019, 1–8. https://doi.org/10.1155/2019/4896862
13.
CarverC. S.ScheierM. F. (2016). Self-regulation of action and affect. In VohsK. D.BaumeisterR. F. (Eds.), Handbook of self-regulation: Research, theory, and applications (3rd ed., pp. 3–23). The Guilford Press.
DelbeckS.VahlsingT.LeonhardtS.SteinerG.HeiseH. M. (2019). Non-invasive monitoring of blood glucose using optical methods for skin spectroscopy – opportunities and recent advances. Analytical & Bioanalytical Chemistry, 411(1), 63–77. https://doi.org/10.1007/s00216-018-1395-x
16.
GrouzetF. M. E.SokolB. W.MüllerU. (2013). Self-Regulation and Autonomy: An Introduction. In SokolB. W.GrouzetF. M. E.MüllerU. (Eds.), Self-Regulation and Autonomy: Social and Developmental Dimensions of Human Conduct (pp. 1–16). Cambridge University Press. https://doi.org/10.1017/CBO9781139152198.003
17.
HannaK. M.WeaverM. T.StumpT. E.DiMeglioL. A.MillerA. R.CrowderS.FortenberryJ. D. (2013). Initial findings: Primary diabetes care responsibility among emerging adults with type 1 diabetes post high school and move out of parental home. Child: Care, Health & Development, 39(1), 61–68. https://doi.org/10.1111/j.1365-2214.2011.01320.x
18.
HelgesonV. S. (2021). Diabetes burnout among emerging adults with type 1 diabetes: A mixed methods investigation. Journal of Behavioral Medicine, 44(3), 368–378. https://doi.org/10.1007/s10865-020-00198-3
19.
HoltT.KumarS. (2015). Insulin therapy. In HoltT.KumarS. (Eds.), ABC of diabetes (7th ed., pp. 47–54). Wiley-Blackwell.
KellyC. S.BergC. A.RamseyM. A.BakerA. C.DonaldsonD. L.SwinyardM. T.. . .WiebeD. J. (2018). Relationships and the development of transition readiness skills into early emerging adulthood for individuals with type 1 diabetes. Children’s Health Care, 47(3), 308–325. https://doi.org/10.1080/02739615.2017.1354294
22.
KrugerS.DeaconE.van RensburgE.SegalD. (2023). Young adult women’s meaning-making of living with type 1 diabetes: Towards growth and optimism. Psychology & Health, 38, 573–590. https://doi.org/10.1080/08870446.2021.1977303
23.
LagunaA. J.RossettiP.Javier Ampudia-BlascoF.VehiJ.BondiaJ. (2014). Postprandial performance of Dexcom (R) SEVEN (R) PLUS and Medtronic (R) Paradigm (R) Veo (TM): Modeling and statistical analysis. Biomedical Signal Processing and Control, 10, 322–331. https://doi.org/10.1016/j.bspc.2012.12.003
24.
LawtonJ.BlackburnM.AllenJ.CampbellF.ElleriD.LeelarathnaL.. . .HovorkaR. (2018). Patients’ and caregivers’ experiences of using continuous glucose monitoring to support diabetes self-management: Qualitative study. BMC Endocrine Disorders, 18(1), Article 12. https://doi.org/10.1186/s12902-018-0239-1
25.
LincolnY. S.GubaE. G. (1985). Establishing trustworthiness. In LincolnY. S.GubaE. G. (Eds.), Naturalistic inquiry (pp. 289–331). Sage.
PennyH. (2016). Cognitive-based theories of personality. In NicholasL. J. (Ed.), Personality psychology (pp. 143–157). Oxford.
28.
PihlaskariA. K.AndersonB. J.EshtehardiS. S.McKinneyB. M.MarreroD. G.ThompsonD.HilliardM. E. (2020). Diabetes disclosure strategies in adolescents and young adult with type 1 diabetes. Patient Education and Counselling, 103(1), 208–213. https://doi.org/10.1016/j.pec.2019.08.019
29.
SaumureK.GivenL. M. (2008). Data saturation. In GivenL. M. (Ed.), The SAGE encyclopedia of qualitative research methods (pp. 195–196). Sage.
30.
SchaieK. W. (2016). Theoretical perspectives for the psychology of aging in a lifespan context. In SchaieK. W.WillisS. L. (Eds.), Handbook of the psychology of aging (8th ed., pp. 3–13). Academic Press.
31.
StebbinsR. A. (2008). Exploratory research. In GivenL. M. (Ed.), The SAGE encyclopedia of qualitative research methods (pp. 327–329). Sage.
32.
VaidE.LansingA. H.StangerC. (2018). Problems with self-regulation, family conflict, and glycemic control in adolescents experiencing challenges with managing type 1 diabetes. Journal of Pediatric Psychology, 43(5), 525–533. https://doi.org/10.1093/jpepsy/jsx134
33.
WeitenW. (2017). Human development across the life span. In WeitenW. (Ed.), Psychology: Themes and Variations (10th ed., pp. 338–377). Cengage Learning.
34.
WeltersA.LammertE. (2014). Diabetes mellitus. In LammertE.ZeebM. (Eds.), Metabolism of human diseases: Organ physiology and pathophysiology (pp. 163–169). Springer.
35.
WillemseM.DeaconE.SegalD. (2018). Life stories managing chronic illness: Young adults’ lived experiences with type 1 diabetes. Journal of Psychology in Africa, 28(4), 336–339. https://doi.org/10.1080/14330237.2018.1507328
36.
WilliamsL.DeaconE.Esmé Van Rensburg SegalD. (2023). Continuous glucose monitoring empowers adolescents to take responsibility of diabetes management, 15(1), Article a3879. https://doi.org/10.4102/phcfm.v15i1.3879
37.
ZimmermanB. J. (1989). Models of self-regulated learning and academic achievement. In ZimmermanB. J.SchunkD. H. (Eds.), Self-regulated learning and academic achievement: Theory, research, and practice (pp. 1–25). Springer-Verlag.
