Barriers to improving glycaemic control in CSII
Everett J., Bowes A., Kerr D.
People with type 1 diabetes ate encouraged to attain an HbA1c level of <7.5% (<58 mmol/mol; NICE, 2009) to reduce the risk of developing long-term complications (Diabetes Control and Complications Trial Research Group, 1993). Continuous subcutaneous insulin infusion (CSII) has been used in Bournemouth since 1998, but the mean HbAi1c of users is 8% (64 mmol/mol). This article describes a study in which seventeen people with type 1 diabetes using CSII therapy participated in focus groups to determine the barriers to achieving better glycaemic I control. Results showed these to be: expectations of increased hypoglycaemia; anticipated restrictions to lifestyle; mistrust of HbA1c results; and the hard work associated with good glycaemic control. These barriers led participants to run their blood glucose levels higher than what they knew was expected from healthcare professionals. Although participants had settled with an HbA1c level of 8%, they were eager to continue learning about getting the most out of their pump and agreed that learning seems to takes place in various ways.