Dataset Information

Living with Type 1 Diabetes as Experienced by Adults with Prolonged Elevated HbA1c: A Qualitative Study.

ABSTRACT:

Introduction

High HbA1c levels in type 1 diabetes (T1D) are associated with increased risk of micro- and macrovascular complications and severe diabetes distress. A more comprehensive understanding of the adult perspective of living with T1D can improve the quality of care. We aimed to describe experiences of living with T1D as an adult with prolonged elevated HbA1c.

Methods

Thirteen adults with T1D and HbA1c > 60 mmol/mol (7.6%) for at least 1 year were individually interviewed via a digital platform. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

Results

The analysis identified an overarching theme, "a lifelong follower", and generated two main categories describing study participants' experience: constraining and manageable. Constraining experiences were explained in obligated control, loss of control, environmental impact, and consequences of diabetes. Manageable experiences were described in everyday life, approach to diabetes, and support in life. Diabetes knowledge in health care and in the general public, and individualized care were important factors in feeling understood, safe, and supported.

Conclusions

The findings revealed the diverse experiences of adults with prolonged elevated HbA1c. Living with T1D, a lifelong non-chosen follower, could be perceived as constraining but manageable in different degrees. A person-centered care approach addressing both dimensions may be beneficial. Experiences of living with and managing diabetes are multifaceted and intertwined with life context and medical prerequisites.

SUBMITTER: Wijk I

PROVIDER: S-EPMC10499710 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Living with Type 1 Diabetes as Experienced by Adults with Prolonged Elevated HbA1c: A Qualitative Study.

Wijk Ingrid I Amsberg Susanne S Andreassen Gleissman Sissel S Toft Eva E Anderbro Therese T Johansson Unn-Britt UB

Diabetes therapy : research, treatment and education of diabetes and related disorders 20230720 10

<h4>Introduction</h4>High HbA1c levels in type 1 diabetes (T1D) are associated with increased risk of micro- and macrovascular complications and severe diabetes distress. A more comprehensive understanding of the adult perspective of living with T1D can improve the quality of care. We aimed to describe experiences of living with T1D as an adult with prolonged elevated HbA1c.<h4>Methods</h4>Thirteen adults with T1D and HbA1c > 60 mmol/mol (7.6%) for at least 1 year were individually interviewed v ...[more]

PMID: 37470946

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Project description:AimsThis study aimed to identify key factors with the greatest influence on glycaemic outcomes in young individuals with type 1 diabetes (T1D) and very elevated glycaemia after 3 months of automated insulin delivery (AID).Materials and methodsData were combined and analysed from two separate and previously published studies with similar inclusion criteria assessing AID (MiniMed 780G) efficacy among young individuals naïve to AID (aged 7-25 years) with glycated haemoglobin A1c (HbA1c) ≥69 mmol/mol (≥8.5%). Univariate and multivariate linear models were performed to explore factors leading to the greatest improvements in HbA1c and time in range 3.9-10.0 mmol/L (70-180 mg/dL; TIR).ResultsA total of 99 young individuals (aged 17.3 ± 4.2 years; baseline HbA1c 92 ± 21 mmol/mol [10.6% ± 1.9%]) were included. After 3 months of AID use, HbA1c improved to 65 ± 16 mmol/mol (8.1% ± 1.5%) (-27 ± 23 mmol/mol; -2.5% ± 2.1% change), and TIR improved from 24.2% ± 13.5% to 58.4% ± 15.4% (p both <0.001). In the multivariate analysis, two key factors for both HbA1c and TIR improvement were identified: high baseline HbA1c (>100 mmol/mol [>11.0%]) and high time in automation mode (>80%), which led to decreased HbA1c by 27.0 mmol/mol (2.4%) and 14.2 mmol/mol (1.3%) and increased TIR by 6.1% and 11.1% (p all <0.05) respectively. Meal announcement frequency >3 times/day and glucose target of 5.5 mmol/L (100 mg/dL) also led to significant increases in TIR. No other factors, including age, prior use of multiple daily injection, ethnicity, gender and optimal active insulin time 2 h, contributed to statistically significant HbA1c or TIR improvement.ConclusionsIn young individuals naive to AID, those with the highest baseline HbA1c and high percentage time in automation experience the greatest benefits after initiation of AID. Sociodemographic background and carbohydrate counting adherence/knowledge should not prevent or delay access to AID technology (ACTRN12621000556842 and ACTRN12622001454763).

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Dataset Information

Living with Type 1 Diabetes as Experienced by Adults with Prolonged Elevated HbA1c: A Qualitative Study.

Introduction

Methods

Results

Conclusions

Publications

Living with Type 1 Diabetes as Experienced by Adults with Prolonged Elevated HbA1c: A Qualitative Study.

Similar Datasets

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