Continuous subcutaneous insulin infusion therapy

: An exploration of the lived experiences of children with Type 1 diabetes mellitus aged 5-11 years

Abstract

In the United Kingdom, the use of continuous subcutaneous insulin infusion therapy (also known as insulin pump therapy) for children with Type 1 diabetes mellitus is increasing. As the most intensive form of insulin therapy, daily management is complex and demanding. However, although many studies have investigated the effectiveness of this treatment in improving blood glucose control, much less is known about children’s own experiences of it, particularly those in the pre-adolescent age group. Therefore, this study aimed to explore in depth how children aged 5 to 11 years with Type 1 diabetes experienced insulin pump therapy in the context of their everyday lives. A hermeneutic phenomenological research design was used, informed by the work of Heidegger. Fifteen children were recruited from two National Health Service paediatric diabetes clinics in England. Data were collected using in depth interviews conducted in children’s homes.

The findings highlighted how children were simultaneously enabled and disabled by insulin pump therapy. As such, its meanings were both complex and nuanced. In particular, this form of treatment had a significant impact on children’s lived bodies - that is, not just their physical, fleshy bodies but also their emotional and psychological well-being and sense of self. The presence of the technology played a central role in these experiences. Children’s active involvement in the management of their own bodies and minds were also revealed. However, despite the considerable effort and hard work that this involved, most children experienced their treatment with satisfaction and enthusiasm.

This study generates new knowledge by proposing that in experiencing insulin pump therapy a young child inhabits a particular type of body. This is defined as the new and
original concept of the lived technological body and aims to capture the impact this treatment had on children’s bodies and minds and the ambiguities and hard work involved in inhabiting and maintaining such an entity.

The findings call for a holistic and contextualised approach to insulin pump therapy in childhood that encourages clinicians to understand this form of treatment as more than simply a bio-medical experience.

Date of Award	Aug 2018
Original language	English
Awarding Institution	University of Brighton
Supervisor	Kay Aranda (Supervisor) & Nina Stewart (Supervisor)