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OBJECTIVE Diabetes technology has improved the lives of people with diabetes (PWD), but there is little research on how insulin pumps and continuous glucose monitoring (CGM) affect couples’ relationships. The purpose of this study was to examine how the use of diabetes technology affects couple interactions. METHODS In a secondary data analysis, we used a multiple-method qualitative analysis, including a constant-comparison approach, to examine similarities and differences in couple interactions related to diabetes technology. PWD and their spouses were interviewed separately, using a semi-structured interview guide; the interviews primarily focused on how couples coped with type 1 diabetes. RESULTS Participants (n = 134 couples) were using an insulin pump or CGM system. Average age was 44 ± 12.05 years for PWD and 44 ± 12.62 years for spouses. Couples’ average length of relationship was 18 ± 12.50 years. Among the PWD, 54 used a pump only, 12 used CGM only, and 68 used both. Four main themes emerged: 1) diabetes technology facilitates shared diabetes management for couples, 2) diabetes technology facilitates spousal involvement in diabetes care, 3) diabetes technology is a source of relationship tension, and 4) diabetes technology causes positive/negative responses to sleep and alarms. CONCLUSION Overall, couples perceived diabetes technology as having a positive effect on their relationship by increasing collaboration, promoting communication, and reducing diabetes burden and vigilance. Technology also was perceived to increase relationship tension, lifestyle inconveniences, and positive/negative responses regarding sleep and alarms. Involvement of spouses in diabetes technology education should be considered.

The rising cost of insulin, costly insurance premiums and the popularity of high deductible insurance plans have resulted in decreased access to insulin. People with diabetes who need financial support for insulin turn to crowdfunding websites, such as GoFundMe, to raise funds. It is unknown if crowdfunding is successful in funding insulin campaigns. This study aims to explore the success and contributing factors for crowdfunding insulin requests in the United States (US). In this retrospective, descriptive study, data were extracted from GoFundMe insulin campaigns for human use in the US from February to April 2019. Data were coded for the following characteristics: campaign requestor, the reason for the request, facial recognition age, gender and race, education level of the post (Flesch-Kincaid), diabetes type, insurance status, disability status, and previous request for pharma support. Descriptive statistics and chi-square tests were utilized to describe and analyze the campaign requestor, purpose and success rate, and contributing factors to campaign success. Of 205 GoFundMe campaigns, 114 (55.0%) were started by the person with diabetes (as opposed to family/friends). Campaigns were created due to insurance issues (i.e., loss of insurance, inadequate insurance coverage; N=125, 61.0%) and requested a median of $1,100 ($50-$200,000), and raised a median of $65 ($0-$6,920). A mean of 29.5% (± 0.6%) of the requested campaign amounts were met. There were no differences in funded status by the characteristics tested. Those who requested lower amounts of money Disclosure J. E. Blanchette: Board Member; Self; JDRF, Consultant; Self; Insulet Corporation, Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care, Research Support; Self; Association of Diabetes Care and Education Specialists. M. Tran: None. E. Iacob: None. T. Oser: Advisory Panel; Self; Cecelia Health, Dexcom, Inc., Advisory Panel; Spouse/Partner; Cecelia Health, Dexcom, Inc. E. Grigorian: None. L. S. Edelman: None. M. L. Litchman: Research Support; Self; Abbott Diabetes.

Background: Family members of older adults with type 1 diabetes (T1D) regularly become part of the diabetes care team yet often lack knowledge about how to become involved to prevent hypo- and hyperglycemia. Real-time continuous glucose monitoring (RT-CGM) with data sharing could facilitate diabetes management among older adults with T1D and their family members. Methods: Older adults with T1D (n=20) and their care partners (n=20) received a RT-CGM data sharing intervention called SHARE. SHARE included dyadic communication strategies, problem-solving strategies, and action planning. People with diabetes (PWD) wore the RT-CGM for 12 weeks while sharing their glucose data with a care partner. Feasibility data were obtained on intervention dose, implementation processes, satisfaction, and diabetes-related quality of life using RT-CGM. Descriptive statistics were used to examine feasibility, satisfaction, and demographic data. Results: The SHARE intervention was feasible, had high self-reported satisfaction for PWD and their care partner, and high adherence (96±6.8%) with wearing the RT-CGM. We found broad improvements in diabetes-related quality of life using RT-CGM in PWD and their care partners. Although the majority of PWD were willing to share hyperglycemia data (55%), several chose not to. The majority of PWD were willing to talk about glucose numbers with a care partner (n=70%). For this feasibility study, the SHARE intervention was not targeted at improving glucose levels but rather on communication and problem-solving strategies. There were no significant trends in the RT-CGM data (e.g., time in range) between baseline and 12 weeks. Conclusion: Older adults with T1D diabetes and their care partners identified the positives of RT-CGM with SHARE as having someone else aware of glucose levels and working together with a partner on diabetes self-management. SHARE may improve dyadic communication and problem-solving around glucose management in older adults. Disclosure N. A. Allen: Research Support; Self; Dexcom, Inc. M. L. Litchman: Research Support; Self; Abbott Diabetes. J. Chamberlain: Speaker’s Bureau; Self; Abbott Diabetes, Dexcom, Inc. E. Grigorian: None. E. Iacob: None. C. Berg: None. Funding University of Utah Center on Aging; University of Utah One U Caregiving Initiative; Dexcom, Inc.

Engagement in Diabetes Online Communities (DOCs) and diabetes online resources have proven benefits, including improved psychosocial, behavioral and clinical outcomes. However, patients report that finding credible and relevant information can be daunting. The aim of this study was to co-design an intervention with people with diabetes (PWD) to train “Peer Connectors” to help adults with type 1 and type 2 diabetes navigate DOCs and diabetes online resources to improve social support. A community advisory board (CAB) of 11 diverse (race, ethnicity, age, diabetes type, diabetes duration) PWD who were active in a variety of DOCs convened over four 2-hour meetings to discuss and prioritize intervention components and outcome measures. Field notes and audio recordings were analyzed to guide development of the D-COPES (Diabetes - Connecting Online Peers to Enhance Support) intervention. The CAB recommended three intervention components: 1) pairing participants to trained Peer Connectors based on matching characteristics/interests, (2) Peer Connectors delivering a small group intervention to orient participants to DOCs and online resources, and (3) Intervention content that includes tailoring to participants’ individual needs and how to identify misinformation. Recommended outcome measures focused on psychosocial (diabetes distress, empowerment), behavioral (self-efficacy, self-care), and clinical outcomes (A1C as secondary outcome), as well as usage of DOCs and online resources. The co-design process centered the D-COPES intervention on avoidance of misinformation and provided strategies to expand the benefits of DOCs to PWD who might not otherwise have the knowledge and skills to engage most effectively. Co-design also served as a form of social validation, ensuring the intervention itself would be of interest and socially relevant to PWD. The D-COPES intervention will be iteratively piloted with 12 participants over 12 weeks. Disclosure M. L. Litchman: Research Support; Self; Abbott Diabetes. T. Oser: Advisory Panel; Self; Cecelia Health, Dexcom, Inc., Advisory Panel; Spouse/Partner; Cecelia Health, Dexcom, Inc. C. Shockley: None. E. Grigorian: None. H. R. Walker: None. E. Wilson: None. A. Thompson: None. J. E. Blanchette: Board Member; Self; JDRF, Consultant; Self; Insulet Corporation, Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care, Research Support; Self; Association of Diabetes Care and Education Specialists. C. Rice: None. M. E. Hilliard: None. Funding Dick and Timmy Burton Foundation