Perceptions in Type 1 Diabetes Mellitus with or Without the Use of Insulin Pump: An Online Study

Abstract

Background: Technological developments concerning the treatment of Type 1 Diabetes Mellitus have been rapid in the latest years. Insulin infusion systems along with continuous glucose monitoring, as well as long-acting insulin analogues, are part of this progress. Objective: The aim of this study is to present the illness perceptions in type 1 diabetes mellitus, with or without the use of an insulin pump. Sexual life and body image among therapy groups subjecting to subcutaneous insulin infusion (CSII) therapy and multiple daily injections (MDI) therapy were also examined. Method: A modified version of the Brief Illness Perception Questionnaire was used. One hundred and nine adults with type 1 diabetes mellitus, (males / females ratio 1:2.3) completed the online survey. Thirty six of them (33%) use CSII therapy and 73 of them (67%) use MDI therapy. Results: Statistically important differences among the CSII and MDI therapy groups were found in treatment control, illness comprehensibility, representations of control, representation of body image and in the perception of sex life. There was no statistically significant difference among the different types of therapy for participants’ negative perception of diabetes. Discussion: Negative perceptions of MDI users in treatment control, illness comprehensibility, representations of control, body image and sex life with the insulin pump, differentiate CSII and MDI therapy groups to a significant degree. According to the research, these parameters seem to interfere with accepting CSII therapy for MDI users and discourage them.

Evaluation of Psychological Resources of Young Adults With Type 1 Diabetes Mellitus During the Transition From Pediatric to Adult Diabetes Clinics: Multicenter Cross-sectional Study

“…In patients with type 2 diabetes, the level of disease acceptance is an independent predictor of adherence [ 24 ]. Some studies also suggest that there is a difference in accepting therapy between users of continuous subcutaneous insulin infusion and MDIs [ 25 ]. Quality of life and illness acceptance were found to be strongly related.…”

Diabetes technology and sexual health: which role?

“…In these studies, great discomfort emerges from users of CSII and CGM during sexual activity that lead to the disconnection of insulin pump in about 75% of cases. The main limitations that are expressed by CSII and CGM users are the negative impact on their body image which does not allow to establish good intimacy with the partner [ 32 , 45 , 46 ], even if it appears difficult to understand why a removable sensor could have such a detrimental effect. In this regard, no studies are available to clearly understand if the beneficial psychological effect outweigh the detrimental ones.…”

Body Image Problems in Individuals with Type 1 Diabetes: A Review of the Literature

“…Of the 51 papers included in this literature review, three studies were conducted with adults (19 years and older) (Herpertz et al, 2001;Mcdonald et al, 2021;Rockliffe-Fidler & Kiemle, 2003); 14 had samples comprising both adolescents [according to the WHO's (1986) definition from ages 10 to 19] and adults (e.g., Bachmeier et al 2020;Rancourt et al, 2019;Robertson et al, 2020); 27 studies were conducted with adolescents only (e.g., Araia et al, 2020;Hartl et al, 2015;Peterson et al, 2018;Wilson et al, 2015); six studies used a sample comprising both children and adolescents (e.g., Olmsted et al, 2008;Peducci et al, 2019); and one study sample consisted exclusively of children (Troncone et al, 2016). In terms of gender, 12 studies were conducted with only female participants (e.g., Gawlik et al, 2016;O'Brien et al, 2011), and 38 with both male and female participants (e.g., Benioudakis, 2020;Verbist & Condon, 2019;Wilson et al, 2015). Only one study (Svensson et al, 2003) was conducted exclusively with male participants.…”

“…Of the 51 studies included in this literature review, the majority (n = 30) used subscales and items from existing tools (e.g., Body Dissatisfaction subscale from the Eating Disorder Inventory; Shape and Weight Concern subscales from the Eating Disorder Examination-Questionnaire) (e.g., Eilander et al, 2017;Peducci et al, 2019;Peterson et al, 2018) or used individual self-report tools (n = 10) designed for the general population (e.g., Body Image Scale; Body Image Disturbance Questionnaire; Sociocultural Attitudes Towards Appearance Questionnaire) (e.g., Gawlik et al, 2016;Troncone et al 2020a, b). Additionally, six studies developed questionnaires/items specifically for the study (e.g., Bachmeier et al 2020;Benioudakis, 2020). Overall, in these studies, body image problems were mainly defined-and therefore assessed-as thoughts or judgments about one's body (or body parts) or evaluations and perceptions of one's general appearance (i.e., body shape/ weight concerns, body dissatisfaction, body image disturbances/distortions, weight perception and satisfaction, concern with body development, body pride); as facets of self-concept (i.e., body image concept, physical self-evaluative and motivational salience, physical self-concept, negative body self, body esteem, self-perception and body awareness); or as the internalization of the thin ideal and the perceived sociocultural appearance-related pressures or positive/negative feelings about their body.…”

“…(e.g., Powers et al, 2012;Wilson et al, 2015); evaluated body image as a mediator of psychological outcomes (Hartl et al, 2015); or assessed changes in body image dissatisfaction in adults with T1D (Herpertz et al, 2001). It is worth noting that among these, two studies focused on the impact of diabetes insulin devices in adolescents and adults with T1D, describing higher negative body representation (as insulin pump use effect) in multiple daily injection users than in continuous subcutaneous insulin infusion (CSII) users (U = 2363, p < 0.0001) (Benioudakis, 2020) or finding no differences in body image dissatisfaction between technology (CSII, continuous glucose monitoring-CGM) users and nonusers (CGM/CSII z = − 0.68/0.10, p > 0.05) (Robertson et al, 2020).…”