title: Parents' experiences of managing their child's diabetes using an insulin pump: a qualitative study.
abstract: OBJECTIVE
  Continuous subcutaneous insulin infusion delivered via a pump is increasingly recommended for younger children with Type 1 diabetes. Our aims were: to understand the impact on parents who care for young children using insulin pumps; to help interpret psychological outcomes reported in quantitative research; and to inform provision of support to future parents.
  
  
  METHODS
  We conducted in-depth interviews with 19 parents of children (aged ≤ 12 years) with Type 1 diabetes who used an insulin pump. Data were analysed thematically.
  
  
  RESULTS
  Parents reported multiple benefits from using insulin pumps, including: no longer having to administer painful injections; fewer restrictions on the frequency, timing and carbohydrate contents of snacks and meals; and improvements in family life and their child's glycaemic control. Parents liked and felt less anxious about using bolus calculators to determine insulin doses; however, parents also described undertaking additional and unanticipated work to manage their child's diabetes using a pump. This included performing more blood glucose tests to calculate insulin doses for snacks and to address their concerns that the pump increased their child's risk of hypoglycaemia. Some parents reported doing additional blood glucose checks because they could adjust pump settings to better manage hypo- and hyperglycaemia.
  
  
  CONCLUSIONS
  Parents liked and perceived benefits for their child and themselves from using an insulin pump; however, parents would benefit from being made aware of the additional work involved in using a pump and also from education and support to address concerns about hypoglycaemia. Better measures to evaluate parents' experiences are also recommended.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh.
authors.forename: D
authors.initials: D
authors.lastname: Rankin
authors.forename: J
authors.initials: J
authors.lastname: Harden
authors.forename: K
authors.initials: K
authors.lastname: Noyes
authors.forename: N
authors.initials: N
authors.lastname: Waugh
authors.forename: K
authors.initials: K
authors.lastname: Barnard
authors.forename: J
authors.initials: J
authors.lastname: Lawton
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D007406:Interview, Psychological; D008019:Life Style; D008297:Male; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012189:Retrospective Studies; D012606:Scotland; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin