How diabetes and insulin therapy affects the lives of people with type 1 diabetes

Abstract

Background: Management of type 1 diabetes places a considerable burden upon patients in terms of frequent insulin injections and blood glucose monitoring. Aims: Patients' fears and thoughts concerning diabetes and treatment were explored in two focus groups. The features of insulin therapy most likely to influence treatment preferences of type 1 patients were investigated. These features would then be used to inform a quantitative patient preference study using a discrete choice experiment. Method: This qualitative study utilised two focus groups, guided by a detailed discussion script based upon clinician input and literature review. Six main topics related to diabetes and insulin therapy were discussed; impact on patient's lifestyle, hypoglycaemic events, predictability and ability to maintain blood glucose levels within recommended targets, injection devices, and negative effects of insulin therapies. In addition, the value people would place on improved insulin therapy measured in terms of their willingness to pay for new therapies, was discussed. Participants were recruited using a screener based upon clinician input. A total of 11 participants attended the two sessions. Transcripts were analysed using content analysis. Results: Participants reported that all six areas were of significant importance in diabetes management. Diabetes and insulin therapy had a huge impact on lifestyle in terms of activity and diet. Fear and experience of hypoglycaemic events were reported as significant concerns. Participants described predicting variation in glucose levels as the key to better management. Participants were willing to pay from £0.70 to £5.00 a day for a better insulin therapy. Conclusion: Diabetes and insulin therapy affects many areas of a patient's life. These data may help understand patients' motivations and treatment preferences, and shape future management and improve diabetic care.Eur Diabetes Nursing 2006; 3(1): 92-97.

Identifying challenges of living with type 1 diabetes: child and youth perspectives

“…These lifestyle changes include diet modification, blood glucose monitoring and insulin administration (Golden , Goldbeck , Nafees et al . , Mednick et al . , Varni et al .…”

Impact of nocturnal hypoglycemic events on diabetes management, sleep quality, and next-day function: results from a four-country survey

“…It is generally recognized that the fear of nocturnal hypoglycemia is substantial for people with diabetes 4,12,14,15 . Nonsevere nocturnal hypoglycemic events (NSNHEs) are also common among people with diabetes 16,17 , and it has been observed that, of all the issues that cause anxiety among individuals with diabetes, patients have reported being most fearful of nocturnal hypoglycemic events 18 .…”

Methodological Aspects of Focus Groups in Health Research

“…For this reason, methodological recommendations on using focus groups in the health care context are quite rare, and researchers rely mainly on general advice from the social sciences (e.g., Krueger, 1988; Morgan, 1993; Morgan & Krueger, 1998; Stewart et al, 2007). Even though focus groups have been used in a great variety of health research fields, such as patients’ treatments and perceptions in the context of specific illnesses (rheumatoid arthritis: for example, Feldthusen, Björk, Forsblad-d’Elia, & Mannerkorpi, 2013; cancer: for example, Gerber, Hamann, Rasco, Woodruff, & Lee, 2012; diabetes: for example, Nafees, Lloyd, Kennedy-Martin, & Hynd, 2006; heart failure: for example, Rasmusson et al, 2014), community health research (e.g., Daley et al, 2010; Rhodes, Hergenrather, Wilkin, Alegría-Ortega, & Montaño, 2006), or invention of new diagnostic or therapeutic methods (e.g., Vincent, Clark, Marquez Zimmer, & Sanchez, 2006), the method and its particular use in health research is rarely reflected. Methodological articles about the focus group method in health care journals mainly summarize general advice from the social sciences (e.g., Kingry et al, 1990; Kitzinger, 1995, 2006), while field-specific aspects of the target groups (patients, doctors, other medical staff) and the research questions (not only sociological but often also medical or technical) are seldom addressed.…”