Self-treating hypoglycaemia: A longitudinal qualitative investigation of the experiences and views of people with Type 1 diabetes

Abstract

Aims Despite improvements in insulin therapy, hypoglycaemia remains an inevitable part of life for many people with Type1 diabetes. Little attention has been paid to how individuals self-treat hypoglycaemia and their likes and dislikes of clinically recommended treatments. We explored participants' experiences of self-treating hypoglycaemia after attending a structured education programme for people with Type1 diabetes. Our aims were: to identify treatments that are acceptable to people with Type1 diabetes; and to provide recommendations for promoting self-treatment in line with clinical guidelines. Methods Thirty adults with Type1 diabetes were recruited from the Dose Adjustment for Normal Eating (DAFNE) programme in the UK. Study participants were interviewed post-course and 6 and 12months later, enabling their experiences to be explored over time. Results Study participants described a poor knowledge of how to self-treat hypoglycaemia correctly pre-course. Post-course, individuals often struggled to adhere to clinically recommended guidelines because of: panic, disorientation, hunger sensations and consequent difficulties ingesting fixed quantities of fast-acting carbohydrate; use of sweets to manage hypoglycaemia; reversion to habituated practices when cognitive impairment as a result of hypoglycaemia supervened; difficulties ingesting dextrose tablets; and other people's anxieties about under-treatment. Conclusions Historical experiences of hypoglycaemia and habituated practices can influence present self-treatment approaches. Professionals need to be aware of the range of difficulties individuals may experience restricting themselves to fixed quantities of fast-acting carbohydrate to manage hypoglycaemia. There may be merit in developing a more acceptable range of treatments tailored to people's own preferences, circumstances and needs. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.