Factors Associated with Adherence to Continuous Subcutaneous Insulin Infusion in Pediatric Diabetes

Babar, Ghufran; Ali, Omar; Parton, Elaine; Hoffmann, Raymond G.; Alemzadeh, Ramin

doi:10.1089/dia.2008.0042

Cited by 22 publications

(18 citation statements)

References 43 publications

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“…In other words, one may say that this study focuses on female adolescents as a high risk group. These findings are consistent with past studies showing that ‘the majority of the patients in the CSII‐discontinuation group were girls, and in puberty’ (12). There may be several possible explanations for this result.…”

Section: Continuous Subcutaneous Glucose Infusion – Insulin Pumpssupporting

confidence: 93%

“…This study raises the question of the selection criteria for insulin pump treatment. The main question in this subject is whether the approach should be constructing a protocol which will evaluate the suitability of a patient to insulin pump from a multi‐professional perspective and will include only patients who are very high functioning (12), or, on the other hand, whether the selection criteria should be more permissive and the main effort of the team would focus on assisting the patient and his/her family to adapt to insulin pump management in the best way they can.…”

Section: Continuous Subcutaneous Glucose Infusion – Insulin Pumpsmentioning

confidence: 99%

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Diabetes technology and the human factor

Liberman

Buckingham

Phillip

2011

International Journal of Clinical Practice

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When developing new technologies for human use the developer should take into consideration not only the efficacy and safety of the technology but also the desire and capabilities of the potential user. Any chronic disease is a challenge for both the patient and his ⁄ her caregivers. This statement is especially true in the case of patients with type 1 diabetes mellitus (T1DM) where adherence to therapy is crucial 24 hours a day 365 days a year. No vacation days are possible for the T1DM patient. It is therefore obvious why any new technology which is developed for helping patients cope with the disease should take into consideration the 'human factor' before, during and after the production process starts. There is no doubt that technology has changed the life of patients with T1DM in the last few decades, but despite the availability of new meters, new syringes, new sophisticated insulin pumps and continuous glucose sensors and communication tools, these technologies have not been well utilised by many patients. It is therefore important to understand why the technology is not always utilised and to find new ways to maximise use and benefits from the technology to as many patients as possible. The present chapter will review papers published in the last year where the patient's ability or willingness was an important factor in the success of the technology. We will try to understand why insulin pumps, glucose sensors and self-monitoring of blood glucose (SMBG) are not used enough or appropriately, whether there is a specific group that finds it more difficult than others to adopt new technologies and what can be done to overcome that issue. For this chapter we chose articles from a Public Medicine review of the literature related to human factors affecting the outcome of studies and of user acceptance of continuous glucose monitoring, insulin infusion pump therapy. We also searched the literature in the field of psychology in order to accurately define the problems that the users of technology are facing (such as adherence, quality of life, motivations, executive functioning etc.) Those articles that had the most important contributions to understanding human factors as well as those highlighting the interface between technology and psychology, were chosen for this review, with emphasis on articles that provide insight into future studies and acceptance of emerging technologies for glycemic control. Background: The evaluation of patientreported outcomes (such as the impact of the technology and satisfaction with the technology) is important in clinical trials of continuous glucose monitoring (CGM). The DirecNet study group had previously developed a CGM Satisfaction Scale (CGM-SAT) along with a Glucose Monitoring Survey (GMS). These scales were used in this larger Juvenile Diabetes Research Foundation randomised clinical trial (JDRF-RCT) of CGM to validate the measures and assess the impact of CGM. CONTINUOUS GLUCOSE SENSORSMethods: The CGM-SAT (a 44-item scale) was used by 224 patients and102 parents to grade...

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Section: Continuous Subcutaneous Glucose Infusion – Insulin Pumpssupporting

confidence: 93%

Section: Continuous Subcutaneous Glucose Infusion – Insulin Pumpsmentioning

confidence: 99%

Diabetes technology and the human factor

Liberman

Buckingham

Phillip

2011

International Journal of Clinical Practice

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“…In this study group the average age of starting and quitting pump therapy is in the adolescent period. As we know this is a difficult time in a person's life, the time when one begins to develop independence; discontinuation of the pump is especially likely during puberty [9]. This is the time during which self-esteem is shaped mostly based on a comparison to certain binding patterns.…”

Section: Discussionmentioning

confidence: 99%

Reasons for the discontinuation of therapy of personal insulin pump in children with type 1 diabetes

Binek¹,

Rembierz-Knoll²,

Polańska

et al. 2015

Pediatr Endocrino Diabetes Metab

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“…In spite of an improvement in overall glycemic control using CSII, many individuals choose to discontinue pump use, and their glucose control returns to baseline. 28 Factors impacting insulin pump discontinuation include ongoing suboptimal glycemic control, poor body image, frustration at the daily demands of the diabetes regimen, higher diabetes-related emotional distress, and less frequent blood sugar monitoring. 29,30 Data from randomized controlled trials and meta-analyses suggest that CGM use leads to improved glucose control.…”

Section: Ap/closed-loop-specific Studiesmentioning

confidence: 99%

Psychosocial Assessment of Artificial Pancreas (AP): Commentary and Review of Existing Measures and Their Applicability in AP Research

Barnard

Hood

Weissberg‐Benchell

et al. 2015

Diabetes Technology & Therapeutics

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Factors Associated with Adherence to Continuous Subcutaneous Insulin Infusion in Pediatric Diabetes

Abstract: Extensive screening by a multidisciplinary diabetes team prior to initiation of CSII regimen results in relatively lower discontinuation rates and a higher chance of maintaining optimal glycemic control (HbA1C < 8%) compared to previous studies.

Cited by 22 publications

References 43 publications

Diabetes technology and the human factor

Diabetes technology and the human factor

Reasons for the discontinuation of therapy of personal insulin pump in children with type 1 diabetes

Psychosocial Assessment of Artificial Pancreas (AP): Commentary and Review of Existing Measures and Their Applicability in AP Research

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