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

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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.

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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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Authors and Affiliations

  1. School of Pharmacy, University of Otago, Dunedin, 9054, New Zealand

    Yasmin H. AbdulAziz, Hesham S. Al-Sallami & Natalie Medlicott

  2. Department of Paediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand

    Esko Wiltshire

  3. Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand

    Jenny Rayns & Benjamin J. Wheeler

  4. Don Beaven Medical Research Hospital, Christchurch, New Zealand

    Jinny Willis

  5. Paediatric Diabetes, Waikato District Health Board, Hamilton, New Zealand

    Joanna McClintock

  6. Women’s and Children’s Health, University of Otago, Dunedin, New Zealand

    Benjamin J. Wheeler

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  1. Yasmin H. AbdulAziz
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  2. Hesham S. Al-Sallami
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  3. Esko Wiltshire
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  4. Jenny Rayns
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  7. Natalie Medlicott
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  8. Benjamin J. Wheeler
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the Paediatric Society of New Zealand Diabetes Clinical Network

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Correspondence to Hesham S. Al-Sallami.

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AbdulAziz, Y.H., Al-Sallami, H.S., Wiltshire, E. et al. Insulin pump initiation and education for children and adolescents – a qualitative study of current practice in New Zealand. J Diabetes Metab Disord 18, 59–64 (2019). https://doi.org/10.1007/s40200-019-00390-6

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  • DOI: https://doi.org/10.1007/s40200-019-00390-6

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