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Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus

Received: 16 December 2018     Accepted: 28 January 2019     Published: 10 May 2019
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Abstract

Aims: This study aims to identify differences in parental satisfaction between three distinct types of intensive insulin therapies used for children with type 1 diabetes (T1D) namely multiple daily injection (MDI), continuous subcutaneous insulin infusion (CSII) and flexible multiple daily injection (fMDI). Materials and Methods: Data was collected over a 6-month period during the quarterly clinic visits. Two modified versions of validated tools- Insulin Treatment Satisfaction Questionnaire (ITSQ) and Diabetes Treatment Satisfaction Questionnaire (DTSQ), were electronically filled in by the parents of children with T1D. This provided information on parental satisfaction on the following areas: inconvenience of regimen, lifestyle flexibility, impression of glycaemic control, fear of hypoglycaemia, diabetic symptoms, treatment barriers, worry, treatment adherence and communication. Results: 34 parents completed the electronic data forms on iSurvey. Parents of the fMDI group were the most confident to avoid severe hypoglycaemia whereas MDI-parents being the least confident, t (21) = 2.12, p = 0.046. There was no statistical difference noted on how confident parents felt to avoid asymptomatic hypoglycaemia, their worry about nocturnal hypoglycaemia, convenience and ease of using insulin in public places, nor was there statistically significant difference in the pain and discomfort felt by their children. Parents of children with fMDI felt the time their children spent with hyperglycemia was higher than the MDI, t (21) = 2.11, p = 0.047. Parents of the CSII group were most likely to continue their current treatment and were also, most likely to recommend the treatment regimen to others. Parents of MDI were least likely to do so, t (20) = 2.12, p =.047 and t (18) = 2.35, p = 0.031. Conclusion: Although this study was conducted with a very small sample size, it has revealed no significant difference in parental satisfaction among MDI, CSII and fMDI groups including parental anxiety and stress, ease of use in public places, convenience, flexibility, parental perception of pain and discomfort experienced by their children and fear of nocturnal hypoglycaemia. However, parents indicated greater confidence in avoiding severe hypoglycaemia in fMDI albeit there was higher glycaemic variability. Parents with CSII were more satisfied with treatment and more likely to recommend their current treatment option to others, than fMDI and MDI, as the preferred mode of treatment.

Published in American Journal of Pediatrics (Volume 5, Issue 2)
DOI 10.11648/j.ajp.20190502.12
Page(s) 43-50
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Type 1 Diabetes Mellitus, Continuous Subcutaneous Insulin Infusion, Flexible Multiple Daily Injection, Multiple Daily Injection, Insulin Treatment Satisfaction Questionnaire, Diabetes Treatment Satisfaction Questionnaire

References
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[8] Group DS. Training in flexible, intensive insulin management to enable dietary freedom in people with Type 1 diabetes: dose adjustment for normal eating (DAFNE) randomized controlled trial. Diabet Med. 2003;20 Suppl 3:4–5.
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[16] Barnard KD, Wysocki T, Ully V, Mader JK, Pieber TR, Thabit H, et al. Insulin pump therapy: impact on the lives of children/young people with diabetes mellitus and their parents. Int J Clin Pharm. 2008 Nov; 105 (11): 927–31.
[17] A. T, R. B, D. I, et al. The social acceptance of future artificial pancreas technology: Parents’ perceptions of pedarpan (pediatrics artificial pancreas). Diabetes Ther [Internet]. 2016; 18: A46--A47.
[18] van Golen LW, Veltman DJ, IJzerman RG, Deijen JB, Heijboer AC, Barkhof F, et al. Effects of Insulin Detemir and NPH Insulin on Body Weight and Appetite-Regulating Brain Regions in Human Type 1 Diabetes: A Randomized Controlled Trial. PLoS One [Internet]. 2014; 9 (4): e94483.
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Cite This Article
  • APA Style

    Anutosh Shee, Sarah Prior, Nicole Reeves, Maria Smith, Sharon Luccisano. (2019). Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus. American Journal of Pediatrics, 5(2), 43-50. https://doi.org/10.11648/j.ajp.20190502.12

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    ACS Style

    Anutosh Shee; Sarah Prior; Nicole Reeves; Maria Smith; Sharon Luccisano. Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus. Am. J. Pediatr. 2019, 5(2), 43-50. doi: 10.11648/j.ajp.20190502.12

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    AMA Style

    Anutosh Shee, Sarah Prior, Nicole Reeves, Maria Smith, Sharon Luccisano. Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus. Am J Pediatr. 2019;5(2):43-50. doi: 10.11648/j.ajp.20190502.12

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  • @article{10.11648/j.ajp.20190502.12,
      author = {Anutosh Shee and Sarah Prior and Nicole Reeves and Maria Smith and Sharon Luccisano},
      title = {Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {2},
      pages = {43-50},
      doi = {10.11648/j.ajp.20190502.12},
      url = {https://doi.org/10.11648/j.ajp.20190502.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190502.12},
      abstract = {Aims: This study aims to identify differences in parental satisfaction between three distinct types of intensive insulin therapies used for children with type 1 diabetes (T1D) namely multiple daily injection (MDI), continuous subcutaneous insulin infusion (CSII) and flexible multiple daily injection (fMDI). Materials and Methods: Data was collected over a 6-month period during the quarterly clinic visits. Two modified versions of validated tools- Insulin Treatment Satisfaction Questionnaire (ITSQ) and Diabetes Treatment Satisfaction Questionnaire (DTSQ), were electronically filled in by the parents of children with T1D. This provided information on parental satisfaction on the following areas: inconvenience of regimen, lifestyle flexibility, impression of glycaemic control, fear of hypoglycaemia, diabetic symptoms, treatment barriers, worry, treatment adherence and communication. Results: 34 parents completed the electronic data forms on iSurvey. Parents of the fMDI group were the most confident to avoid severe hypoglycaemia whereas MDI-parents being the least confident, t (21) = 2.12, p = 0.046. There was no statistical difference noted on how confident parents felt to avoid asymptomatic hypoglycaemia, their worry about nocturnal hypoglycaemia, convenience and ease of using insulin in public places, nor was there statistically significant difference in the pain and discomfort felt by their children. Parents of children with fMDI felt the time their children spent with hyperglycemia was higher than the MDI, t (21) = 2.11, p = 0.047. Parents of the CSII group were most likely to continue their current treatment and were also, most likely to recommend the treatment regimen to others. Parents of MDI were least likely to do so, t (20) = 2.12, p =.047 and t (18) = 2.35, p = 0.031. Conclusion: Although this study was conducted with a very small sample size, it has revealed no significant difference in parental satisfaction among MDI, CSII and fMDI groups including parental anxiety and stress, ease of use in public places, convenience, flexibility, parental perception of pain and discomfort experienced by their children and fear of nocturnal hypoglycaemia. However, parents indicated greater confidence in avoiding severe hypoglycaemia in fMDI albeit there was higher glycaemic variability. Parents with CSII were more satisfied with treatment and more likely to recommend their current treatment option to others, than fMDI and MDI, as the preferred mode of treatment.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Parental Satisfaction on Multiple Daily Injections, Insulin Pump and Flexible Multiple Daily Injections Used for Children with Type 1 Diabetes Mellitus
    AU  - Anutosh Shee
    AU  - Sarah Prior
    AU  - Nicole Reeves
    AU  - Maria Smith
    AU  - Sharon Luccisano
    Y1  - 2019/05/10
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ajp.20190502.12
    DO  - 10.11648/j.ajp.20190502.12
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 43
    EP  - 50
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20190502.12
    AB  - Aims: This study aims to identify differences in parental satisfaction between three distinct types of intensive insulin therapies used for children with type 1 diabetes (T1D) namely multiple daily injection (MDI), continuous subcutaneous insulin infusion (CSII) and flexible multiple daily injection (fMDI). Materials and Methods: Data was collected over a 6-month period during the quarterly clinic visits. Two modified versions of validated tools- Insulin Treatment Satisfaction Questionnaire (ITSQ) and Diabetes Treatment Satisfaction Questionnaire (DTSQ), were electronically filled in by the parents of children with T1D. This provided information on parental satisfaction on the following areas: inconvenience of regimen, lifestyle flexibility, impression of glycaemic control, fear of hypoglycaemia, diabetic symptoms, treatment barriers, worry, treatment adherence and communication. Results: 34 parents completed the electronic data forms on iSurvey. Parents of the fMDI group were the most confident to avoid severe hypoglycaemia whereas MDI-parents being the least confident, t (21) = 2.12, p = 0.046. There was no statistical difference noted on how confident parents felt to avoid asymptomatic hypoglycaemia, their worry about nocturnal hypoglycaemia, convenience and ease of using insulin in public places, nor was there statistically significant difference in the pain and discomfort felt by their children. Parents of children with fMDI felt the time their children spent with hyperglycemia was higher than the MDI, t (21) = 2.11, p = 0.047. Parents of the CSII group were most likely to continue their current treatment and were also, most likely to recommend the treatment regimen to others. Parents of MDI were least likely to do so, t (20) = 2.12, p =.047 and t (18) = 2.35, p = 0.031. Conclusion: Although this study was conducted with a very small sample size, it has revealed no significant difference in parental satisfaction among MDI, CSII and fMDI groups including parental anxiety and stress, ease of use in public places, convenience, flexibility, parental perception of pain and discomfort experienced by their children and fear of nocturnal hypoglycaemia. However, parents indicated greater confidence in avoiding severe hypoglycaemia in fMDI albeit there was higher glycaemic variability. Parents with CSII were more satisfied with treatment and more likely to recommend their current treatment option to others, than fMDI and MDI, as the preferred mode of treatment.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Paediatrics, University of Tasmania, Tasmania, Australia

  • Clinical School, University of Tasmania, Tasmania, Australia

  • Clinical School, University of Tasmania, Tasmania, Australia

  • Tasmanian Health Service, Tasmania, Australia

  • Tasmanian Health Service, Tasmania, Australia

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