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Insulin pump initiation and education for children and adolescents – a qualitative study of current practice in New Zealand

  • Yasmin H. AbdulAziz
  • Hesham S. Al-SallamiEmail author
  • Esko Wiltshire
  • Jenny Rayns
  • Jinny Willis
  • Joanna McClintock
  • Natalie Medlicott
  • Benjamin J. Wheeler
  • the Paediatric Society of New Zealand Diabetes Clinical Network
Research Article

Abstract

Purpose

Worldwide, the use of insulin pumps for the management of type 1 diabetes is increasing. There are no national or international published guidelines and few guidance recommendations detailing the education and training required to commence insulin pump therapy. The aim of this study is to describe current clinical practice regarding initiation of insulin pump therapy in children and adolescents with type 1 diabetes in New Zealand.

Methods

Pediatric diabetes nurse specialists from selected New Zealand hospitals (n = 16) were identified and invited to participate in this qualitative study. For those consenting, structured interviews were conducted. The questions covered basic hospital demographics and various aspects of insulin pump initiation including pump start planning, education, and aspects of follow-up and after-care.

Results

The response rate was 100% (16 out of 16 hospitals). Diabetes clinics interviewed varied in size from 50 to 450 pediatric patients and frequency of insulin pump use from 11% - 46%. Clinical practice differed between clinics. Important differences related to: use of continuous glucose monitoring (12/16); and differing views on immediate vs. delayed use of pump advanced features. Location of pump starts also varied, with both in-patient (2/16) and out-patient (14/16) approaches seen. The motivations and beliefs relating to these various pump start approaches also varied.

Conclusions

Differences seen between hospitals reflected team preference, and possibly a lack of consensus/guidance from the medical literature. Lessons may be learnt and further rationalisation and improvement in education remains possible by combining and adopting strengths from different hospitals.

Keywords

Type 1 diabetes Pediatric Education Insulin pump Continuous subcutaneous insulin infusion 

Notes

Acknowledgments

The authors wish to thank all the participants and the Paediatric Society of New Zealand Diabetes Clinical Network for their time and assistance with this study. The authors would also like to thank the School of Pharmacy, University of Otago, Dunedin, New Zealand for the funding given to carry out this project.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Yasmin H. AbdulAziz
    • 1
  • Hesham S. Al-Sallami
    • 1
    Email author
  • Esko Wiltshire
    • 2
  • Jenny Rayns
    • 3
  • Jinny Willis
    • 4
  • Joanna McClintock
    • 5
  • Natalie Medlicott
    • 1
  • Benjamin J. Wheeler
    • 3
    • 6
  • the Paediatric Society of New Zealand Diabetes Clinical Network
  1. 1.School of PharmacyUniversity of OtagoDunedinNew Zealand
  2. 2.Department of Paediatrics and Child HealthUniversity of Otago WellingtonWellingtonNew Zealand
  3. 3.Paediatric EndocrinologySouthern District Health BoardDunedinNew Zealand
  4. 4.Don Beaven Medical Research HospitalChristchurchNew Zealand
  5. 5.Paediatric DiabetesWaikato District Health BoardHamiltonNew Zealand
  6. 6.Women’s and Children’s HealthUniversity of OtagoDunedinNew Zealand

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