scholarly journals Socioeconomic disparities in access to intensive insulin regimens for adults with type 1 diabetes: a qualitative study of patient and healthcare professional perspectives

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Anne Scott ◽  
Alicia O’Cathain ◽  
Elizabeth Goyder
Keyword(s):  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Diabetes Education ◽  
Socioeconomic Disparities ◽  
Socioeconomic Groups ◽  
Diabetes Specialist ◽  
Lower Socioeconomic ◽  
Specialist Services ◽  
Specialist Nurses

Abstract Background Type 1 diabetes is a complex chronic condition which requires lifelong treatment with insulin. Health outcomes are dependent on ability to self-manage the condition. Socioeconomic inequalities have been demonstrated in access to treatment and health outcomes for adults with type 1 diabetes; however, there is a paucity of research exploring how these disparities occur. This study explores the influence of socioeconomic factors in gaining access to intensive insulin regimens for adults with type 1 diabetes. Methods We undertook a qualitative descriptive study informed by a phenomenological perspective. In-depth face-to-face interviews were conducted with 28 patients and 6 healthcare professionals involved in their care. The interviews were analysed using a thematic approach. The Candidacy theory for access to healthcare for vulnerable groups framed the analysis. Results Access to intensive insulin regimens was through hospital-based specialist services in this sample. Patients from lower socioeconomic groups had difficulty accessing hospital-based services if they were in low paid work and because they lacked the ability to navigate the healthcare system. Once these patients were in the specialist system, access to intensive insulin regimens was limited by non-alignment with healthcare professional goals, poor health literacy, psychosocial problems and poor quality communication. These factors could also affect access to structured diabetes education which itself improved access to intensive insulin regimens. Contact with diabetes specialist nurses and attendance at structured diabetes education courses could ameliorate these barriers. Conclusions Access to intensive insulin regimens was hindered for people in lower socioeconomic groups by a complex mix of factors relating to the permeability of specialist services, ability to navigate the healthcare system and patient interactions with healthcare providers. Improving access to diabetes specialist nurses and structured diabetes education for vulnerable patients could lessen socioeconomic disparities in both access to services and health outcomes.

Habit and Routine Interventions with Emerging Adults with Diabetes: An Integrative Review

2021 ◽  
pp. 019394592110322
Author(s):  
Kathleen M. Hanna ◽  
Jed R. Hansen ◽  
Kim A. Harp ◽  
Kelly J. Betts ◽  
Diane Brage Hudson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Emerging Adults ◽  
Text Messaging ◽  
Integrative Review ◽  
Self Management ◽  
Future Research ◽  
Medical Librarian

Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users’ perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.

Prevention and early help for eating disorders in young people with type 1 diabetes

2021 ◽  
pp. 135910452199417
Author(s):  
Rosie Oldham-Cooper ◽  
Claire Semple
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Early Intervention ◽  
Young People ◽  
Current Evidence ◽  
Future Directions ◽  
Team Collaboration ◽  
Children And Young People ◽  
Specialist Services

There is building evidence that early intervention is key to improving outcomes in eating disorders, whereas a ‘watch and wait’ approach that has been commonplace among GPs and other healthcare professionals is now strongly discouraged. Eating disorders occur at approximately twice the rate in individuals with type 1 diabetes compared to the general population. In this group, standard eating disorder treatments have poorer outcomes, and eating disorders result in a particularly high burden of morbidity. Therefore, our first priority must be prevention, with early intervention where disordered eating has already developed. Clinicians working in both eating disorders and diabetes specialist services have highlighted the need for multidisciplinary team collaboration and specific training, as well as improved treatments. We review the current evidence and future directions for prevention, identification and early intervention for eating disorders in children and young people with type 1 diabetes.

scholarly journals Self-Management as a Mediator of Family Functioning and Depressive Symptoms With Health Outcomes in Youth With Type 1 Diabetes

2013 ◽  
Vol 36 (9) ◽  
pp. 1254-1271 ◽  
Author(s):  
Robin Whittemore ◽  
Lauren Liberti ◽  
Sangchoon Jeon ◽  
Ariana Chao ◽  
Sarah S. Jaser ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Depressive Symptoms ◽  
Family Functioning ◽  
Health Outcomes ◽  
Self Management

Who Needs Diabetes Education? A Qualitative Analysis of Emerging Adults With Type 1 Diabetes

2021 ◽  
Vol 47 (6) ◽  
pp. 436-446
Author(s):  
Margot E. Porter ◽  
Michelle L. Litchman ◽  
Ernest G. Grigorian ◽  
Julia E. Blanchette ◽  
Nancy A. Allen
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Online Community ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Further Education ◽  
Transitional Period ◽  
Primary Care Clinics ◽  
Glycemic Management

Background The purpose of this study is to explore the diabetes self-management education (DSME) needs of emerging adults with type 1 diabetes mellitus (T1DM) because addressing these needs may facilitate optimal glycemic management during this challenging transitional period. Methods A hybrid qualitative design was utilized. Emerging adults and parents of emerging adults were recruited from endocrinology and primary care clinics and through a Utah-specific T1DM online community. Interviews were conducted to asses needs to achieve target A1C. Data were interpreted thematically. Results Emerging adults with T1DM (N = 33) and parents of emerging adults with T1DM (N = 17) were interviewed. Three main themes emerged: (1) mixed desire for personal DSME; (2) I don’t need the education, others do; and (3) health care provider (HCP) attributes that make a difference. Associated subthemes were reported. Conclusions Emerging adults reported that further education for themselves was not needed, although newly diagnosed individuals would benefit from increased training in diabetes management. Although many emerging adults had a supportive social network, they endorsed the need for greater public education to avoid diabetes misinformation. Emerging adults felt more connected with HCPs that had diabetes-specific training (ie, endocrinologist) or those who personally live with T1DM.

Analyzing Online Social Support Within the Type 1 Diabetes Community

2018 ◽  
pp. 59-84 ◽  
Author(s):  
Kristin G. Maki ◽  
Aisha K. O'Mally
Keyword(s):  
Social Support ◽  
Social Media ◽  
Type 1 Diabetes ◽  
Heart Disease ◽  
Health Outcomes ◽  
Chronic Illnesses ◽  
Informational Support ◽  
Online Social Support ◽  
Social Media Platforms

Social support has been linked with many health outcomes, ranging from heart disease to depression. Although its importance has been recognized, less is known about how individuals with chronic illnesses may use social media to provide and seek social support. This chapter's focus is on the way in which people with Type 1 diabetes (T1D) use social media to provide and solicit social support. A mixed-methods approach is utilized. First, posts from two social media platforms were qualitatively content analyzed. Second, the data were quantitatively analyzed to provide a finer-grained understanding of the messages. The results show informational support as the most prevalent on both sites, although there are some differences in content and use. This chapter's implications highlight the importance of social media as a conduit for social support among caregivers and individuals affected by T1D.

scholarly journals Insulin Bolusing Software: The Potential to Optimize Health Outcomes in Type 1 Diabetes Mellitus

2013 ◽  
Vol 7 (3) ◽  
pp. 646-652 ◽  
Author(s):  
Kimberly A. Driscoll ◽  
Suzanne Bennett Johnson ◽  
John Hogan ◽  
Elizabeth Gill ◽  
Nancy Wright ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Type 1 Diabetes Mellitus ◽  
Optimize Health
Sign in / Sign up

Export Citation Format

Share Document