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Exp Clin Endocrinol Diabetes 2018; 126(03): 162-167
DOI: 10.1055/s-0043-110479
Article
© Georg Thieme Verlag KG Stuttgart · New York

Experiences in Sensor-Augmented Pump Therapy in Families with two Children with Type 1 diabetes: A Qualitative Study

Franziska Bomba
1   Department of Paediatrics and Adolescent Medicine, University of Luebeck, Luebeck, Germany
,
Esther Müller-Godeffroy
1   Department of Paediatrics and Adolescent Medicine, University of Luebeck, Luebeck, Germany
,
Simone von Sengbusch
1   Department of Paediatrics and Adolescent Medicine, University of Luebeck, Luebeck, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received 06. April 2017
revised 29. April 2017

accepted 02. Mai 2017

Publikationsdatum:
27. Juli 2017 (online)

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Abstract

Background Caring for a child with type 1 diabetes is a tremendous challenge for a family. The aim of the study was to explore the experiences of transition to sensor-augmented pump therapy (SAP) in families with 2 affected children and the internal and external conditions which potentially impede or facilitate the adjustment process.

Methods 5 families (9 parents, 8 children and adolescents) who used the SAP technology for 6 months were interviewed to describe their experiences. The interviews were analysed using thematic content analysis.

Results Qualitative analysis of the transcribed interviews revealed that the adaptation process to SAP consisted of several phases and differed among families. There were benefits as well as hassles of using SAP with regard to managing the diabetes, and psychosocial issues: school and peer relations, as well as family relations. While parents clearly regarded the improved metabolic control and hypoglycaemic safety as the most important benefits of SAP, the hassles reported as most important covered a wide range, from technical problems of the system to family conflicts. On the whole, families rated the experience of using SAP as a positive one, with most recommending SAP to other families as long as they were willing to come to terms with the technology and commit to the work and time involved.

Conclusion Sensor-augmented pump therapy can be extremely beneficial and a resource for families who care for more than one child with diabetes. During the adaptation process there is a great need of education and frequent follow-up e. g., by telemedical support.

Key words

insulin infusion systems - blood glucose self-monitoring - telemedicine - qualitative research
 

  • References

  • 1 Phillip M, Danne T, Shalitin S. et al. Use of continuous glucose monitoring in children and adolescents. Pediatr Diabetes 2012; 13: 215-228
    CrossrefPubMedGoogle Scholar
  • 2 Cengiz E, Sherr JL, Weinzimer SA. et al. New-generation diabetes management: Glucose sensor-augmented insulin pump therapy. Expert Rev Med Devices 2011; 8: 449-458
    CrossrefPubMedGoogle Scholar
  • 3 Hirose M, Beverly EA, Weinger K. Quality of life and technology: Impact on children and families with diabetes. Curr Diab Rep 2012; 12: 711-720
    CrossrefPubMedGoogle Scholar
  • 4 Larson NS, Pinsker JE. The role of continuous glucose monitoring in the care of children with type 1 diabetes. Int J Pediatr Endocrinol 2013; 2013: 8
    CrossrefPubMedGoogle Scholar
  • 5 Ludwig-Seibold CU, Holder M, Rami B. et al. Continuous glucose monitoring in children, adolescents, and adults with type 1 diabetes mellitus: Analysis from the prospective DPV diabetes documentation and quality management system from Germany and Austria. Pediatr Diabetes 2012; 13: 12-14
    CrossrefPubMedGoogle Scholar
  • 6 Phillip M, Danne T, Shalitin S. et al. Use of continuous glucose monitoring in children and adolescents. Pediatr Diabetes 2012; 13: 215-228
    CrossrefPubMedGoogle Scholar
  • 7 Weinzimer S, Xing D, Tansey M. et al. Prolonged use of continuous glucose monitors in children with type 1 diabetes on continuous subcutaneous insulin infusion or intensive multiple-daily injection therapy. Pediatr Diabetes 2009; 10: 91-96
    CrossrefPubMedGoogle Scholar
  • 8 Floyd B, Chandra P, Hall S. et al. Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus. J Diabetes Sci Technol 2012; 6: 1094-1102
    CrossrefPubMedGoogle Scholar
  • 9 Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes. Diabetes Care 2009; 32: 1947-1953
    CrossrefPubMedGoogle Scholar
  • 10 Pickup JC, Holloway MF, Samsi K. Real-time continuous glucose monitoring in type 1 diabetes: A qualitative framework analysis of patient narratives. Diabetes Care 2015; 38: 544-550
    PubMedGoogle Scholar
  • 11 Rashotte J, Tousignant K, Richardson C. et al. Living with sensor-augmented pump therapy in type 1 diabetes: Adolescents’ and parents’ search for harmony. Can J Diabetes 2014; 38: 256-262
    CrossrefPubMedGoogle Scholar
  • 12 Streisand R, Swift E, Wickmark T. et al. Paediatric parenting stress among parents of children with type 1 diabetes: The role of self-efficacy, responsibility, and fear. J Pediatr Psychol 2005; 30: 513 -521
    CrossrefPubMedGoogle Scholar
  • 13 Markowitz JT, Pratt K, Aggarwal J. et al. Psychosocial correlates of continuous glucose monitoring use in youth and adults with type 1 diabetes and parents of youth. Diabetes Technol Ther 2012; 14: 523-526
    CrossrefPubMedGoogle Scholar
  • 14 Mayring P. Qualitative Inhaltsanalyse: Grundlagen und Techniken [Qualitative Content Analysis – Theoretical Foundation and Basic Procedures]. Weinheim: Beltz; 2010
    Google Scholar
  • 15 Tansey M, Laffel L, Cheng J. et al. Satisfaction with continuous glucose monitoring in adults and youths with Type 1 diabetes. Diabet Med 2011; 28: 1118-1122
    CrossrefPubMedGoogle Scholar
  • 16 Cemeroglu AP, Stone R, Kleis L. et al. Use of a real-time continuous glucose monitoring system in children and young adults on insulin pump therapy: Patients’ and caregivers’ perception of benefit. Pediatr Diabetes 2010; 11: 182-187
    PubMedGoogle Scholar
  • 17 Diabetes Research in Children Network (DirecNet) Study Group. Psychological aspects of continuous glucose monitoring in pediatric type 1 diabetes. Pediatr Diabetes 2006; 7: 32
    PubMedGoogle Scholar
  • 18 Kruger D, Marcus AO. Psychological motivation and patient education: a role for continuous glucose monitoring. Diabetes Technol Ther 2000; 2: 93-97
    CrossrefPubMedGoogle Scholar
  • 19 Ives B, Sikes K, Urban A. et al. Practical aspects of real-time continuous glucose monitors The Experience of the Yale Children’s Diabetes Program. Diabetes Educ 2010; 36: 53-62
    CrossrefPubMedGoogle Scholar
  • 20 Laffel L. Improved accuracy of continuous glucose monitoring systems in pediatric patients with diabetes mellitus: Results from two studies. Diabetes Technol Ther 2016; 18: 2-23
    PubMedGoogle Scholar
  • 21 Ramchandani N, Arya S, Ten S. et al. Real-life utilization of real-time continuous glucose monitoring: The complete picture. J Diabetes Sci Technol 2011; 5: 860-870
    CrossrefPubMedGoogle Scholar
  • 22 Tsalikian E, Fox L, Weinzimer S. et al. Feasibility of prolonged continuous glucose monitoring in toddlers with type 1 diabetes. Pediatr Diabetes 2012; 13: 301-307
    CrossrefPubMedGoogle Scholar
  • 23 Ritholz M. Is continuous glucose monitoring for everyone? Consideration of psychosocial factors. Diabetes Spectr 2008; 21: 287-289
    CrossrefPubMedGoogle Scholar
  • 24 Gehr B. SPECTRUM, das Schulungs- und Behandlungsprogramm zum kontinuierlichen Glukosemonitoring. Diabetes Stoffwech H 2015; 25: 437-440
    PubMedGoogle Scholar
  • 25 Mauras N, Beck R, Xing D. et al. Diabetes Research in Children Network (DirecNet) Study Group. A randomized clinical trial to assess the efficacy and safety of real-time continuous glucose monitoring in the management of type 1 diabetes in young children aged 4 to <10 years. Diabetes Care 2012; 35: 204-210
    CrossrefPubMedGoogle Scholar
  • 26 Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Quality-of-life measures in children and adults with type 1 diabetes. Diabetes Care 2010; 33: 2175-2177
    CrossrefPubMedGoogle Scholar
  • 27 Block JM, Buckingham B. Use of real-time continuous glucose monitoring technology in children and adolescents. Diabetes Spectr 2008; 21: 84-90
    CrossrefPubMedGoogle Scholar