Shared Medical Decision Making in Pediatric Diabetes
Type 1 Diabetes Mellitus
About this trial
This is an interventional health services research trial for Type 1 Diabetes Mellitus focused on measuring type 1 diabetes mellitus, adolescence, adherence, insulin pump, continuous subcutaneous insulin infusion, continuous glucose monitor, shared medical decision making
Eligibility Criteria
Inclusion Criteria:
- Type 1 diabetes for 1 year or more
- At least 2 diabetes clinic visits at the enrolling site in the prior year
- Considered by treating endocrinologist to be a candidate for insulin pump or continuous glucose monitor
- Intent to continue care at Nemours for 1 year
- Internet access at home, school, work or relative's home
Exclusion Criteria:
- Open case with child protection agency
- Unable to read and speak English
Sites / Locations
- Nemours Children's Clinic
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Usual Clinical Practice (UCP)
Shared Medical Decision Making (SMDM)
UCP participants will receive the same clinical and educational management for candidates for insulin pump or continuous glucose monitoring that is received by similar patients who are not enrolled in this study. The respective endocrinology practices at the enrolling sites all strive to meet or exceed the current American Diabetes Association Standards for Clinical Practice in the management of type 1 diabetes in this population. Thorough patient education is the cornerstone of that care, especially regarding the incorporation of insulin pumps and continuous glucose monitors into the treatment regimen for a given patient.
Participants randomized to SMDM receive all components of UCP supplemented with access to the decision aid website pertinent to the medical decision of interest (pump or CGM). Adolescents and parents will receive password-protected, secure access to the decision for their use until a decision is reached. The platform will then generate a summary report that the adolescent and parent will discuss with a diabetes nurse and then a visit with the treating endocrinologist will be scheduled to conclude the SMDM intervention for that adolescent and parent.