Little is known about the psychosocial challenges associated with optimal management of continuous subcutaneous insulin infusion (CSII). This study explored possibilities and barriers to managing diabetes with CSII among individuals with type 1 diabetes.
We conducted individual semi-structured qualitative interviews with 21 adults with type 1 diabetes treated with CSII, recruited from two Danish diabetes outpatient clinics. The participants were purposefully sampled for heterogeneity. An interview guide with 5 pre-defined themes was used to guide the interviews and the qualitative content analysis.
The 21 participants varied according to sex [women, n=11], age [range 22-71 years], education [short, n=7; medium, n=8; long, n=6], diabetes duration [range 9-66 years], HbA1c [range 37-91 mmol/mol], CSSI duration [range 2-37 years], technical devices [CGM with CSSI, n=14].
Deductive data analysis sorted narrative responses into pre-defined themes (Everyday life with diabetes; CSII history; Everyday life with CSII; Expectations/Outcomes of CSII; Needs and preferences). Inductive analyses indicated that perceptions of CSII therapy were influenced by multiple factors, of which devices and device management were not necessarily to the fore. Individual understandings of what a good life with diabetes was and how to achieve it were the primary drivers of diabetes management. Peer support was identified as a useful resource to improve daily management of CSII.
Possibilities and barriers to CSII therapy are determined by more than functionality of CSII devices. Support with an everyday life perspective from health care professionals and from peers may enhance diabetes management and alleviate challenges.