I don't have the choice to burnout; experiences of parents of children with type 1 diabetes

Objectives: Comparison of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in achieving glycemic control in youths with type 1 diabetes mellitus (T1DM). Methods: Retrospective cohort study including 2 matched groups of youths with T1DM treated by CSII or MDI in a tertiary specialized children’s hospital in Saudi Arabia. Children and adolescents aged up to 18 years, diagnosed with T1DM and using CSII or MDI, from the period 2016 to 2018. Patients on MDI were newly-diagnosed patients with T1DM who had the disease for only 1 year duration; all CSII patients had at least 1 to 2 years of T1DM but who had just started on pumps in the past 3 months. We excluded patients with other autoimmune diseases, non-ambulatory patients and those admitted to hospital for non-diabetes reasons. Primary outcome was HbA1c at 1, 2, and 3 years, with weight gain as a secondary outcome. Ambulatory glycemic profile was analyzed from a subset of patients using intermittently scanned continuous glucose monitoring (isCGM). Results: A total of 168 youths with T1DM (n = 129 in the MDI group, n = 39 in the CSII group) were included. The CSII group consistently had lower HbA1c levels compared to the MDI group throughout a 3-year follow up period: 8.1% versus 10.1, P-value < .001 at 1 year, 7.5% versus 10.1% at 2 years, P-value < .001, 8.9% versus 10.3% at 3 years, P-value = .033. Body mass index significantly increased in both groups at 1 year, although greater in CSII group. In a subgroup using isCGM (n = 37 on MDI and n = 29 on CSII), the CSII group had a lower average blood glucose (194 mg/dL vs 228 mg/dL, P-value = .028) and a lower estimated HbA1c level (8.4% vs 9.6%, P-value = .022). Conclusion: Treatment with CSII resulted in lower HbA1c compared to MDI in our cohort, which was sustained over a 3-year period.

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“…Understanding the factors that help drive patient motivation is essential to reduce rates of diabetes burn-out. 32 - 34 ,44…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh

Babiker

Alammari

Aljuraisi

et al. 2022

Clin Med Insights Endocrinol Diabetes

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“…Support from the health team was represented in this review in the form of training, follow-up, use of play-based strategies and the identification of new support networks. The use of play-based strategies has been a primary tool for health professionals who deal with children and adolescents with T1DM, as it encourages self-care and good health practices [ 142 , 143 ]. Such strategies can also be innovative for T1DM education using tools such as games, mobile apps and even humanoid robots [ 144 , 145 ].…”

Section: Discussionmentioning

confidence: 99%

Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review

et al. 2022

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Background Among the treatments for type 1 diabetes mellitus (T1DM), Continuous Subcutaneous Insulin Infusion (CSII) is a device that infuses insulin through the subcutaneous tissue in an uninterrupted manner and that comes closest to the physiological secretion of insulin. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM. There is a lack of reviews that systematically gather the mounting evidence about the use of CSII in children and adolescents with T1DM. Therefore, the aim of this review was to group and describe primary and secondary studies on the use of CSII in children and adolescents with T1DM. Methods A systematic mapping review was performed based on searches in the following databases: PubMed, Embase, CINAHL, Lilacs and PsycINFO, using a combination of descriptors and keywords. The screening of the studies was carried out with the aid of the Rayyan software and reading in full was conducted independently by two reviewers. The data extraction of the studies was performed using an extraction tool adapted and validated by researchers specialized in diabetes. The data were analyzed according to the content analysis technique. The map from geocoding of the studies was produced using the ArcGis 10.5 software. Results A total of 113 studies were included in the review, including primary studies, literature reviews and gray literature publications. The content analysis of the results of the studies allowed for the identification of four categories: 1) metabolic control; 2) support networks; 3) benefits of using CSII; and 4) challenges of using CSII, each category having its respective subcategories. The review also made it possible to conduct a rigorous mapping of the literature on the use of CSII considering the location of development and the design of the studies. Conclusions The use of CSII should be indicated by health professionals able to prepare children, adolescents, and their families for the treatment of T1DM, and, despite being a technological device, it may not be suitable for the entire pediatric population.

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“…Although the exact prevalence of burnout among parents of children with CCN is unknown, parents who experience burnout within this group are far from alone. Societal awareness, especially in general and clinical practice, may be a first step towards alleviating some of the strain that parents feel (Abdoli, Vora, Smither, Roach, & Vora, 2020). Furthermore, integrating care for families of children with CCN may also alleviate some of the factors giving rise to parental burnout.…”

Section: Discussionmentioning

confidence: 99%

Understanding burnout among parents of children with complex care needs: A scoping review informed by a stakeholder consultation

Patty¹,

Meeteren²,

Willemen³

et al. 2021

Preprint

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Background: The concept of parental burnout has been proposed to be helpful for describing and understanding the impact of parenting children with complex care needs (CCN). The objective of this scoping review was to investigate the aims, methods, and results of research on burnout among parents of children with CCN, and to inform the interpretation as well as implications for research and practice through a stakeholder consultation.Methods: The scoping review was guided by the JBI Reviewers’ Manual for scoping reviews. Primary studies on burnout among parents of children with CCN were identified through a comprehensive search of peer reviewed and grey literature. Metadata and findings were extracted and compiled for further synthesis and interpretation, guided by a stakeholder consultation, involving parents of children with CCN (n = 6), healthcare professionals (n = 3), and researchers (n = 3). The stakeholder consultation was structured according to a Delphi consultation method. Results: A total of 57 articles were eligible for inclusion. Prevalence of burnout among parents of children with CCN varied between 20 and 77%. Parents of children with CCN reported on average higher burnout scores than parents of children without CCN. While all studies focused on parents with children with CCN, very few studies specifically focused on burnout within the context of parenting a child with CCN. Stakeholders endorsed the importance of studies into the multifactorial determination of burnout in the context of having children with CCN. Conclusion:The concept of parental burnout highlights the extremes of stress and burden experienced by parents of children with CCN. By focusing more on contextualized definitions of parental burnout, research may unravel the complex interplay between personal and contextual factors pertaining to risk and resilience.

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I don't have the choice to burnout; experiences of parents of children with type 1 diabetes

Cited by 20 publications

References 22 publications

The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh

The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh

Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review

Understanding burnout among parents of children with complex care needs: A scoping review informed by a stakeholder consultation

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