Reconsidering your perceptions: exploring the lifeworld of a young person with type 1 diabetes

Introduction Views of young people with type 1 diabetes are vital in developing quality services, yet research on their lifestyle and use of web and mobile technology to support their condition is sparse. We aimed to develop a deeper understanding of the perspective of a young person with type 1 diabetes and construct a picture of their lifeworld. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Results A number of themes emerged, including: • The effects of technology on living with diabetes. • Use of social media, mobile phones and Apps to obtain information and support. • Feelings about the health services they used. We also uncovered several interesting issues that concern patients in this age group: • Understanding the isolation that young people might feel at this age. • Personal attitudes to type 1 diabetes and initiating improvement. • Fear, discomfort and being seen as different. • Why we might embrace and show negative views of the condition. • Rethinking the use of Facebook. Summary We obtained a deeper and more empathetic understanding of the feelings of young people with type 1 diabetes, and the issues that are important to them. This data will be used to look at local services, producing more effective systems for support and self-management which take into account the feelings of patients and make them more likely to engage with technology

Why haven’t YOU thought of that? Over 15 great mobile app ideas for improving the quality of life of a young person with type 1 diabetes

Introduction The use of mobile devices to look up health-related information is of increasing importance to young people, who have a radically different view of technology than either their parents or practitioners. We explored what young people with type 1 diabetes required from social media and mobile technology by seeking their views and ideas, enabling the eventual design of innovative new tools to help them engage with health services and their own health in their preferred manner. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Baseline data analysis was then undertaken to locate potential ideas for mobile App development. Results Over fifteen innovative new ideas for mobile Apps not currently available were suggested including: • Twitter - contacting other people with type 1 diabetes, an emergency link for contacting the health service and receiving direct messages from clinic staff which would help to personalise diabetes care. • Hypoglycaemia awareness - advice on what to do for friends, family and colleagues who might come into contact with the participant. • Illness information. • News/information on existing/new diabetes technology. Summary We have explored what young people with type 1 diabetes want from social media and mobile technology, so that the design and implementation of new technology to help self-management is more patient-centred, more likely to be used and more likely to improve quality of life

The development of an innovative mobile phone app for type 1 diabetes alcohol education

Introduction Social media is being increasingly used to try and engage young people with their healthcare issues. However, most mobile diabetes applications (Apps) do not include personalised patient education, a key facet of diabetes self-management. We sought the views and ideas of young people with type 1 diabetes to enable the design of innovative new Apps which might help to improve their quality of life. This project highlights an innovative, patient-centric approach to the development and production of a health based mobile App concerning diabetes education about alcohol. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Baseline data analysis was undertaken to locate potential ideas for mobile App development, with suggestions chosen needing to reflect interviewee requirements and to meet clinic goals. Results Interviewees suggested that they would find a guide which could be accessed via a mobile device about alcohol limits and the effects of alcohol on their diabetes particularly useful on a night out. An App about alcohol and diabetes, ‘Start Safe, Stay Safe’, was developed with further input from young people with type 1 diabetes and clinic staff. Summary In developing a mobile App about alcohol and diabetes, we have shown how young people with type 1 diabetes can participate effectively in the design and implementation of new technology which they can then use to improve their quality of life

The benefits of oestrogens on postprandial lipid metabolism are lost in post-menopausal women with Type 2 diabetes

AIMS: Women with Type 2 diabetes appear to lose the protection against cardiovascular disease (CVD) afforded by oestrogens. We examined the effects of oestrogen hormone replacement therapy (HRT) on postprandial clearance of dietary fat in non-diabetic and diabetic post-menopausal women. METHODS: In a cross-sectional study, fasting subjects [HRT+ and HRT- control and diabetic women; Type 2 diabetes (DM) HRT+n = 8, DM HRT-n = 14, control HRT+n = 7, control HRT-n = 11] consumed a meal containing the stable isotope 1,1,1-[13]C-tripalmitin, with blood and breath sampled for 6 and 24 h, respectively, in the postprandial period. RESULTS: In diabetic women, there were no differences between the HRT+ and HRT- groups for any of these parameters. In contrast, in HRT+ compared with HRT- control women, the triglyceride (TG) area under the curve was lower [AUC; HRT+ median (range) 7.7 (4.1, 12.8) mmol/l per 6 h, HRT- 9.7 (3.9, 18.5) mmol/l per 6 h, P < 0.05] and [13]C-palmitic acid in the TG fraction was also lower [HRT+ 23.2 (10.3, 41.3) ng/ml per 6 h, HRT- 47.7 (12.6, 77.2) ng/ml per 6 h, P < 0.05], suggesting the lower postprandial triglyceridaemia associated with HRT in non-diabetic women is because of better chylomicron clearance. CONCLUSIONS: The oestrogen-associated advantage in clearance of dietary lipid we observed in non-diabetic post-menopausal women is not seen in post-menopausal diabetic women. This is likely to promote an atherogenic lipoprotein profile and may contribute to the loss of CVD protection seen in diabetic women