Experiences of young adults with type 1 diabetes while using alcohol and recreational drugs: An interpretative phenomenological analysis (IPA) of semi-structured interviews

Pastor, Adam; O'Brien, Casey L; Teng, James T. C.; Conn, Jennifer; Loh, Margaret; Collins, Lisa; MacIsaac, Richard J; Bonomo, Yvonne

doi:10.1016/j.diabres.2018.04.029

Cited by 11 publications

(22 citation statements)

References 15 publications

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“…In one study, simulated social drinking conditions using a vodka aperitif, evening meal with wine, followed by cognac resulted in superimposable blood glucose levels and insulin profiles in the control and alcohol groups with no impact on glucose in the evening and overnight . In comparison, YP when drinking socially showed increased glucose variability and less risk of hypoglycaemia compared to a control group, with participants drinking pre‐mixed sweetened beverages and consuming carbohydrate prior to and after drinking to prevent hypoglycaemia – which has also been reported by other authors …”

Section: Glycaemic Effects Of Alcoholic Beverages Food Consumption mentioning

confidence: 53%

“…In patient guidelines, hyperglycaemia as a consequence of drinking alcoholic beverages is not commonly acknowledged, despite studies demonstrating hyperglycaemia rather than hypoglycaemia . Furthermore, in clinical practice and experience, hyperglycaemia is observed to occur, which may be a result of a hypoglycaemia prevention strategy, with carbohydrate consumption being used deliberately to cause hyperglycaemia . Hypoglycaemia is the greatest risk of alcohol consumption described in guidelines for people with T1DM written by various different ‘diabetes associations’ (n=13).…”

Section: Effects Of Acute Alcohol Consumption On Blood Glucosementioning

confidence: 99%

“…Despite the reported excess consumption in YP, this age group has a lower weekly intake compared to other age groups, with a tendency towards binge drinking . This could be due to the increasing prevalence of recreational drug use which, for a person with T1DM, can have a lesser impact on blood glucose levels, especially overnight and the following day, with hyperglycaemia being the most common effect …”

Section: Introductionmentioning

confidence: 99%

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A review of the challenges, glycaemic risks and self‐care for people with type 1 diabetes when consuming alcoholic beverages

et al. 2020

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Evidence‐based information for people with type 1 diabetes mellitus (T1DM) when consuming alcoholic beverages is sparse and simplistic. In clinical practice, erratic blood glucose levels with hypoglycaemia and hyperglycaemia are regularly observed, with episodes of severe hypoglycaemia being a potential risk. Preventative health behaviour strategies are often based on trial and error, with deliberately caused hyperglycaemia being a common tactic. Although important, there are no systematic reviews that synthesise the research evidence on the acute effects of alcohol on blood glucose and the impact in real‐life. We aimed to investigate the acute effect of alcoholic beverages on blood glucose, and to use appropriate evidence to recommend self‐care advice to help maintain safe glycaemic control in people with T1DM. A literature search from eight bibliographic databases was performed. Fifteen appropriate publications were identified. Most original research was performed in a laboratory environment and demonstrated inconsistencies in the effects of alcohol on blood glucose. Few studies were conducted in the real‐life environment, with advice from ‘diabetes associations’ focusing on abstinence rather than alcohol harm reduction strategies. In conclusion, key components to consider when designing future interventions include: the biochemical response to alcohol; the role of exogenous insulin; the presence and timing of carbohydrate foodstuffs in relation to alcohol; the impact of the constituents and amount of an alcoholic beverage consumed; and the effects of alcohol on cognition and behaviours.

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Section: Glycaemic Effects Of Alcoholic Beverages Food Consumption mentioning

confidence: 53%

Section: Effects Of Acute Alcohol Consumption On Blood Glucosementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A review of the challenges, glycaemic risks and self‐care for people with type 1 diabetes when consuming alcoholic beverages

et al. 2020

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“…Young adults with Type 1 diabetes consume alcohol and recreational drugs at rates similar to their peers [2], however, this use is associated with higher rates of hospitalization and mortality relative to young adults without Type 1 diabetes [3,4]. Research has demonstrated that young adults with Type 1 diabetes may inconsistently apply a range of harm minimization measures to reduce the risk of substance use, yet rarely discuss these measures with clinicians [5,6]. As recreational drug use becomes more common and with a decrease in regulation for both medicinal and recreational use in many jurisdictions, clinicians are increasingly likely to encounter young adults with Type 1 diabetes wishing to discuss the impact of drug use on glycaemic control.…”

mentioning

confidence: 99%

“…We performed a survey of clinicians regarding their approach to young adults with Type 1 diabetes who use alcohol and illicit drugs. The survey, developed by the research team following qualitative work with young adults with Type 1 diabetes who use substances [5], aimed to determine screening levels, recognition and advice given by a variety of clinician groups. Clinicians were invited to complete a 15-question online survey via the Australian Diabetes Educators Association (ADEA) newsletter, at a presentation at the Australian Diabetes Congress (ADC) and at a number of presentations to local endocrinology unit meetings in Melbourne, Australia.…”

mentioning

confidence: 99%

Clinicians feel comfortable discussing alcohol but not illicit drug use with young adults with Type 1 diabetes: a survey of clinicians

Pastor¹,

Conn²,

et al. 2019

Diabet. Med.

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systematic and robust way. Such research should also include qualitative studies to ensure that the perspective of the person with diabetes is accounted for.People with diabetes sometimes use the term diabulimia themselves [11,12], and we appreciate the importance of support groups for individuals struggling with issues relating to eating, weight, body shape or insulin. We believe, however, that for professionals in particular it is important to be mindful in adopting terminology and avoid jargon. This should of course not stop us raising awareness about insulin omission as a dangerous weight loss strategy in Type 1 diabetes. Finally, to advance our understanding and management of this complex combination, we advocate multidisciplinary consensus meetings, including individuals with lived experience, to discuss current research findings and future actions, including prevention, assessment tools and tailored treatments. In this context, finding the appropriate terminology and definitions for the different clinical presentations of eating disorder psychopathology in persons with Type 1 diabetes is a priority.

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Using stories to explore the lived experience of alcohol consumption in people with diabetes mellitus

Charlton,

MacDonald

2023

Practical Diabetes

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Background: Evidence supports the risks of dangerous episodes of hypoglycaemia, hyperglycaemia, or extreme glucose variability in type 1 diabetes during and after alcohol consumption. Minimal evidence regarding preventative self‐care strategies exists, and people with type 1 diabetes can develop personal tactics to overcome risks. Combining the lived experience of managing alcohol consumption while living with diabetes will enrich new patient and health care professional education.Methods: Participants were recruited from social media, and attended between one and three online storytelling workshops. Demographic data were collected by questionnaire, and qualitative data were collected by note‐taking during the online sessions and evaluated by thematic analysis.Results: Nine participants aged 18–36 years (type 1 diabetes = seven [three female], and type 2 diabetes = two [both male]) were recruited. Insulin administration was by multiple daily injection therapy (n=5 including one type 2 diabetes), continuous subcutaneous insulin infusion (n=3) without hybrid closed loop, and sulphonylurea plus morning long‐acting analogue insulin (n=1 type 2 diabetes). From the nine participant stories three diabetic ketoacidosis, three hypoglycaemia, and one extreme glucose variability episodes occurred. Four clustered themes were found: living with diabetes, managing alcohol, app development suggestions, and future development suggestions.Discussion: New insights discovered were: distressing glucose risks including diabetic ketoacidosis episodes, misinterpretation of glucose and intoxication symptoms, trial and error approaches, and non‐disclosure to health care professionals regarding severe glucose situations. Copyright © 2023 John Wiley & Sons.

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Experiences of young adults with type 1 diabetes while using alcohol and recreational drugs: An interpretative phenomenological analysis (IPA) of semi-structured interviews

Cited by 11 publications

References 15 publications

A review of the challenges, glycaemic risks and self‐care for people with type 1 diabetes when consuming alcoholic beverages

A review of the challenges, glycaemic risks and self‐care for people with type 1 diabetes when consuming alcoholic beverages

Clinicians feel comfortable discussing alcohol but not illicit drug use with young adults with Type 1 diabetes: a survey of clinicians

Using stories to explore the lived experience of alcohol consumption in people with diabetes mellitus

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