Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting.
Before 2016, no Laotian child was known to have survived type 1 diabetes (T1D) into adulthood. There is an ongoing need for action. Our study explored, in supported youth, the impact of transitioning from a twice to multiple daily injection (MDI) regimen on glycaemic control, and their views/perceptions around how the switch affected their T1D management/quality of life.
Data were obtained from medical records/semi-structured interviews; participants recruited as they switched to an MDI regimen. Quantitative data were stratified into glycated haemoglobin (HbA1c) 6/12 months before/after the switch, and male/female sex; associations examined using t-tests. Qualitative data were analysed using Gibb's framework.
Overall, 24 youth (62.5% female) changed regimens. Mean±SD HbA1c 6/12-month periods before the switch were 8.8±2.3% (73.0 mmol/mol)/8.3±2.2% (67.0 mmol/mol), respectively. In the same periods after the switch, HbA1c improved to 7.6±2.7% (60.0 mmol/mol)/7.7±2.1% (61.0 mmol/mol), respectively. No differences were observed between sexes.Interviews were conducted with 15 youth (73.3% female); mean ages at T1D diagnosis/the switch time were 10.6 and 14.3 years, respectively. Describing how transitioning to an MDI regimen affected T1D management/quality of life, three themes emerged: pragmatism; empowerment and agency; and foundations of success.
The study provides valuable insights that will guide future work in supporting youth with T1D.
Data were obtained from medical records/semi-structured interviews; participants recruited as they switched to an MDI regimen. Quantitative data were stratified into glycated haemoglobin (HbA1c) 6/12 months before/after the switch, and male/female sex; associations examined using t-tests. Qualitative data were analysed using Gibb's framework.
Overall, 24 youth (62.5% female) changed regimens. Mean±SD HbA1c 6/12-month periods before the switch were 8.8±2.3% (73.0 mmol/mol)/8.3±2.2% (67.0 mmol/mol), respectively. In the same periods after the switch, HbA1c improved to 7.6±2.7% (60.0 mmol/mol)/7.7±2.1% (61.0 mmol/mol), respectively. No differences were observed between sexes.Interviews were conducted with 15 youth (73.3% female); mean ages at T1D diagnosis/the switch time were 10.6 and 14.3 years, respectively. Describing how transitioning to an MDI regimen affected T1D management/quality of life, three themes emerged: pragmatism; empowerment and agency; and foundations of success.
The study provides valuable insights that will guide future work in supporting youth with T1D.
Authors
Ng Ng, Manivong Manivong, Khambuapha Khambuapha, Martin Martin, Ooi Ooi, James James
View on Pubmed