Science Journal of Public Health

| Peer-Reviewed |

Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment

Received: 20 June 2018    Accepted:     Published: 21 June 2018
Views:       Downloads:

Share This Article

Abstract

This study focuses on how parents make mistakes when administering insulin doses in treating hyperglycemia in their T1D diabetic children. This research employed a qualitative approach, conducting 58 semi-structured, in-depth interviews with 37 Saudi Arabian and Australian parents with T1D children, and 20 combined health professionals and company representatives. A conceptual tree analysis of the interviews was carried out using Atlas software. The initial coding was analyzed into two major themes: Misestimations and misunderstandings of insulin correction doses; and Mistakes in using injection tools and techniques. Each of these themes affords insight into correcting parents’ mistakes in insulin doses through a variety of techniques and technologies for T1D-related insulin delivery. In general, parents had made both corrected and uncorrected mistakes, and surprisingly, many were unfamiliar with the focal meaning of correction doses and how they are estimated or used. Despite significant efforts in diabetes education, the incidence of adverse health outcomes continues. This study shows that parental mistakes in insulin doses for treating hyperglycemia are crucial and involved issues. There are many ways to address these mistakes, and this study seeks to provide recommendations in order improve diabetes care practices.

DOI 10.11648/j.sjph.20180603.15
Published in Science Journal of Public Health (Volume 6, Issue 3, May 2018)
Page(s) 91-99
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Insulin Dosage, Parent, Type 1 Diabetes, Mistake, Hyperglycemia

References
[1] Jayakumar, R., Bhavani, N., & Pavithran, P. (2013). Diabetes in children and adolescents. New Delhi: JP Medical Ltd, Diabetes in Children and Adolescents. 2013: JP Medical Ltd.
[2] Fleisher, G., & Ludwig, S. (2010). Textbook of pediatric emergency medicine. Philadelphia: Lippincott Williams & Wilkins, Textbook of pediatric emergency medicine. 2010: Lippincott Williams & Wilkins.
[3] Daneman, D., Type 1 diabetes. The Lancet, 2006. 367 (9513): p. 847-858.
[4] Roemer, J. A. d. a. g. t. r. a. c. w. d. V. A. D. A., Roemer, J. (2011). America] n diabetes association guide to raising a child with diabetes. Virginia: American Diabetes Assoiation.
[5] Wolfsdorf, J., N. Glaser, and M. A. Sperling, Diabetic Ketoacidosis in Infants, Children, and Adolescents A consensus statement from the American Diabetes Association. Diabetes care, 2006. 29 (5): p. 1150-1159.
[6] Kanikarla-Marie, Preeti, and Sushil K. Jain, Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes. Free Radical Biology and Medicine, 2016. 95: p. 268-277.
[7] Hanas, R. T. d. i. c., adolescents, and young adults: How to become an expert on your own diabetes. Bristol: Class Publishing Ltd, Type 1 diabetes in children, adolescents, and young adults: how to become an expert on your own diabetes. 2007: Class Publishing Ltd.
[8] Vehik, K., Hamman, R., Lezotte, D., Norris, J., Klingensmith, G., & Bloch, C. (2007). Increasing incidence of type 1 diabetes in 0 to 17 year old Colorado youth. Diabetes Care, 30 (3), 503-509, Increasing incidence of type 1 diabetes in 0-to 17-year-old Colorado youth. Diabetes care, 2007. 30 (3): p. 503-509.
[9] Hulkower, R., Pollack, R., & Zonszein, J. (2014). Understanding hypoglycemia in hospitalized patients. Diabetes Management, 4 (2), 165-176, Understanding hypoglycemia in hospitalized patients. Diabetes management (London, England), 2014. 4 (2): p. 165.
[10] Magaji, V. and J. M. Johnston, Inpatient management of hyperglycemia and diabetes. Clinical Diabetes, 2011. 29 (1): p. 3-9.
[11] Truong, T. H., et al., Errors in the Administration Technique of Insulin Pen Devices: A Result of Insufficient Education. Diabetes Therapy, 2017. 8 (2): p. 221-226.
[12] Trief, P. M., et al., Incorrect insulin administration: a problem that warrants attention. Clinical Diabetes, 2016. 34 (1): p. 25-33.
[13] Umpierrez, G. E., et al., Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 2012. 97 (1): p. 16-38.
[14] Ambler, G., & Cameron, F. (2010). Caring for diabetes in children and adolescents. Wales: Combined Children’s Diabetes Services Caring for diabetes in children and adolescents. 2010.
[15] reiser, J. G. c. a. n. J. o. P. a. E. N., 35 (12), 671-672, Glycemic control and nutrition. 2011, Sage Publications Sage CA: Los Angeles, CA.
[16] Brook, C., & Dattani, M. (2012). Handbook of clinical pediatric endocrinology. New Jersey: John Wiley& Sons, Handbook of clinical pediatric endocrinology. 2012: John Wiley & Sons.
[17] Pettitt, D., Talton, J., Dabelea, D., Divers, J., Imperatore, G., & Lawrence J. (2009). The search for diabetes in youth study. Diabetes Care, 37 (2), 402-408. doi: 10.2337/dc13-1838, The search for diabetes in youth study. Diabetes Care, 2009. 37 (2),: p. 402-408.
[18] Niedel, A., Traynor, M., Mckee, M., & Grey, M. (2012). Parallel vigilance: Parents' dual focus following diagnosis of type 1 diabetes mellitus in their young child. Health, 0 (0), 1-20, Parallel vigilance: parents’ dual focus following diagnosis of Type 1 diabetes mellitus in their young child. Health:, 2012. 17 (3): p. 246-265.
[19] Young-Hyman, D., & Peyrot, M. (2012). Psychosocial care for people with diabetes. Virginia: American Diabetes Association, Psychosocial care for people with diabetes. 2012: American Diabetes Association.
[20] Turchin, A., Matheny, M., & Shubina, M. (2009). Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care, 32 (7), 1153-1157, Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care, 2009. 32 (7): p. 1153-1157.
[21] Draznin, B. M. d. a. h. i. t. h. s. A. c. s. g. V. A. D. A., Managing Diabetes and Hyperglycemia in the Hospital Setting: A Clinician's Guide. 2016: American Diabetes Association.
[22] Cryer, P. H., functional brain failure, and brain death. Journal of Clinical Investigation, 117 (4), 868-870, Hypoglycemia, functional brain failure, and brain death. The Journal of clinical investigation, 2007. 117 (4): p. 868-870.
[23] Patton, S., Dolan, L., Smith, L., Brown, M., & Powers, S. (2013). Examining mealtime behaviors in families of young children with type 1 diabetes on intensive insulin therapy. Eating Behaviour, 14 (4), 464-467, Examining mealtime behaviors in families of young children with type 1 diabetes on intensive insulin therapy. Eating behaviors, 2013. 14 (4): p. 464-467.
[24] Taylor, R., Williams, S., Farmer, V., & Taylor, B. (2013). Changes in physical activity over time in young children: a longitudinal study using accelerometers. PLoS One, 8 (11), 81567, Changes in physical activity over time in young children: a longitudinal study using accelerometers. PLoS One, 2013. 8 (11): p. e81567.
[25] Schatz, D., Haller, M., & Atkinson, M. (2010). Type 1 diabetes, an issue of endocrinology and metabolism clinics of North America, E-book. Amsterdam: Elsevier Health Sciences, Type 1 Diabetes, An Issue of Endocrinology and Metabolism Clinics of North America, E-Book. Vol. 39. 2010: Elsevier Health Sciences.
[26] Faulkner, M., Family Responses to Children with Diabetes and Their Influence on Self-Care., Family responses to children with diabetes and their influence on self-care. Journal of Pediatric Nursing, 1996. 11 (2): p. 82-93.
[27] Bruno, A., Gregori, D., & Caropreso, A. (2008). Normal glucose values are associated with a lower risk of mortality in hospitalized patients. Diabetes Care, 31 (11), 2209-2210, Normal glucose values are associated with a lower risk of mortality in hospitalized patients. Diabetes Care, 2008. 31 (11): p. 2209-2210.
[28] Moghissi, E., Korytkowski, M., & Dinardo, M. (2009). American association of clinical endocrinologists and american diabetes consensus statement on inpatient glycemic conrol. Diabetes Care. 32 (6), 1119-1131, American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes care, 2009. 32 (6): p. 1119-1131.
[29] Sullivan-Bolyai, S. L., M. (2011). Parent mentor perspectives on providing social support to empower parents. The Diabetes Educator, 37, (3), 34-43, Parent mentor perspectives on providing social support to empower parents. The Diabetes Educator, 2011. 37 (1): p. 35-43.
[30] Barnea-Goraly, N., Raman, M., Mazaika, P., Marzelli, M., Hershley, T., & Weinzimer, S. (2014). Alterations in white matter structure in young children with type 1 diabetes. Diabetes Care, 37 (2), 332-340. doi:10.2337/dc13-1388, Alterations in white matter structure in young children with type 1 diabetes. Diabetes Care, 2014. 37 (2): p. 332-340.
[31] Mertig, R. N. s. g. t. t. d. s. m., second edition. New York: Spring Publishing Company, Nurses' Guide to Teaching Diabetes Self-management. 2011: Springer Publishing Company.
[32] Gagnum, V., Stene, L. C., Leivestad, T., Joner, G. and Skrivarhaug, T., 2017. Long-term mortality and end-stage renal disease in a type 1 diabetes population diagnosed at age 15–29 years in Norway. Diabetes care, 40 (1), pp. 38-45., Long-term mortality and end-stage renal disease in a type 1 diabetes population diagnosed at age 15–29 years in Norway. Diabetes care, 2017. 40 (1): p. 38-45.
[33] Dabelea, D., Stafford, J. M., Mayer-Davis, E. J., D’Agostino, R., Dolan, L., Imperatore, G., Linder, B., Lawrence, J. M., Marcovina, S. M., Mottl, A. K. and Black, M. H., 2017. Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood. Jama, 317 (8), pp. 825-835.
[34] Bruttomeso, D., & Grassi, D. (2014). Technological advances in the treatment of type 1 diabetes. Basel: Karger Medical and Scientific Publishers, Technological advances in the treatment of type 1 diabetes. 2014: Karger Medical and Scientific Publishers.
[35] Korytkowski, M., Salata, R.,& Koerbel, G. (2009). Insulin therapy and glycemic control in hospitalized patients with diabetes during ennteral nutrition therapy: A randomized controlled clinical trial. Diabetes Care, 32 (3), 594-596, Insulin therapy and glycemic control in hospitalized patients with diabetes during enteral nutrition therapy: a randomized controlled clinical trial. Diabetes care, 2009. 32 (4): p. 594-596.
[36] Dungan, K., Braithwaite, S., & Preiser, J. (2009). Stress hyperglycemia. Lancet, 373 (9677), 1798-1807, Stress hyperglycaemia. The Lancet, 2009. 373 (9677): p. 1798-1807.
[37] Steele, C., Hagopian, W., & Gitelman, S. (2004). Insulin secretion in type 1 diabetes. Diabetes, 53 (4), 426-433, Insulin secretion in type 1 diabetes. Diabetes, 2004. 53 (2): p. 426-433.
[38] Bienso, R., Ringholm, S., & Kiilerich, K. (2012). GLUT4 and glycogen synthase are key players in bed rest-induced insulin resistance. Diabetes. 61 (10), 1090-1099, GLUT4 and Glycogen Synthase Are Key Players in Bed Rest–Induced Insulin Resistance. Diabetes, 2012. 61 (5): p. 1090-1099.
[39] Marzelli, M., Masaika, P., Barnea-Goraly, N., Hershey, T., Tsalikian, E.,& Tamborlane, W. (2014). Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes. Diabetes, 63 (1), 343-353, Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes. Diabetes, 2014. 63 (1): p. 343-353.
[40] Trochim, W. M. and J. P. Donnelly, 'Research methods knowledge base', 2001.
[41] Browne, G. J. and M. B. Rogich, An empirical investigation of user requirements elicitation: Comparing the effectiveness of prompting techniques. Journal of Management Information Systems, 2001. 17 (4): p. 223-249.
[42] Gasmavov, A., &Umipierrez, G. (2012). Medical nutrition therapy in hospitalized patients with diabetes. Current Diabetes Reports. 12 (3), 92-100, Medical nutrition therapy in hospitalized patients with diabetes. Current diabetes reports, 2012. 12 (1): p. 93-100.
[43] Streisand, R., Mackey, E., Elliot, B., Mednick, L., Slaughter, I., & Turek, J. (2008). Parental anxiety and depression associated with caring for a child newly diagnosed with type 1 diabetes: Opportunities for education and counseling. Patient Education Cou, Parental anxiety and depression associated with caring for a child newly diagnosed with type 1 diabetes: opportunities for education and counseling. Patient education and counseling, 2008. 73 (2): p. 333-338.
[44] Seshiah, V. M. c. o. d. A. E. H. S., Microvascular Complications of Diabetes-ECAB. 2009: Elsevier Health Sciences.
[45] Jiang, H., Stryer, D., Friedman, B., & Andrews, R. (2003). Multiple hospitalizations for patients with diabetes. Diabetes Care, 26 (5), 1421-1426, Multiple hospitalizations for patients with diabetes. Diabetes care, 2003. 26 (5): p. 1421-1426.
[46] Hilliard, M., Monaghan, M., Cogen, F., & Streisand, R. (2011). Parent stress and child behavior among young children with type 1 diabetes. Child Care Health Developmemt, 37 (2), 224-232 Parent stress and child behaviour among young children with type 1 diabetes. Child: care, health and development, 2011. 37 (2): p. 224-232.
[47] Herrin, M. N. c. i. t. t. o. e. d. L. R., Nutrition counseling in the treatment of eating disorders. 2012: Routledge.
[48] Trief, P. M., Cibula, D., Rondriguez, E., Akel, B. & Weinstok, R. S. (2016). Incorrect insulin administration: a problem that warrants attention. Clinical Diabetes, 34, 25-33., Incorrect insulin administration: a problem that warrants attention. Clinical Diabetes, 2016. 34 (1): p. 25-33.
[49] Geller, B., & Delbello, M. (2008). Treatment of bipolar disorder in children and adolescents. New York: Guilford Press, Treatment of bipolar disorder in children and adolescents. 2008: Guilford Press.
Author Information
  • College of Admins and Financial Sciences, Taif University, Taif, Saudi Arabia; School of Business IT & Logistics, RMIT University, Melbourne, Australia

  • School of Business IT & Logistics, RMIT University, Melbourne, Australia

  • School of Business IT & Logistics, RMIT University, Melbourne, Australia

Cite This Article
  • APA Style

    Wala’a Barifah, Bill Davey, Vince Bruno. (2018). Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment. Science Journal of Public Health, 6(3), 91-99. https://doi.org/10.11648/j.sjph.20180603.15

    Copy | Download

    ACS Style

    Wala’a Barifah; Bill Davey; Vince Bruno. Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment. Sci. J. Public Health 2018, 6(3), 91-99. doi: 10.11648/j.sjph.20180603.15

    Copy | Download

    AMA Style

    Wala’a Barifah, Bill Davey, Vince Bruno. Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment. Sci J Public Health. 2018;6(3):91-99. doi: 10.11648/j.sjph.20180603.15

    Copy | Download

  • @article{10.11648/j.sjph.20180603.15,
      author = {Wala’a Barifah and Bill Davey and Vince Bruno},
      title = {Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment},
      journal = {Science Journal of Public Health},
      volume = {6},
      number = {3},
      pages = {91-99},
      doi = {10.11648/j.sjph.20180603.15},
      url = {https://doi.org/10.11648/j.sjph.20180603.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.sjph.20180603.15},
      abstract = {This study focuses on how parents make mistakes when administering insulin doses in treating hyperglycemia in their T1D diabetic children. This research employed a qualitative approach, conducting 58 semi-structured, in-depth interviews with 37 Saudi Arabian and Australian parents with T1D children, and 20 combined health professionals and company representatives. A conceptual tree analysis of the interviews was carried out using Atlas software. The initial coding was analyzed into two major themes: Misestimations and misunderstandings of insulin correction doses; and Mistakes in using injection tools and techniques. Each of these themes affords insight into correcting parents’ mistakes in insulin doses through a variety of techniques and technologies for T1D-related insulin delivery. In general, parents had made both corrected and uncorrected mistakes, and surprisingly, many were unfamiliar with the focal meaning of correction doses and how they are estimated or used. Despite significant efforts in diabetes education, the incidence of adverse health outcomes continues. This study shows that parental mistakes in insulin doses for treating hyperglycemia are crucial and involved issues. There are many ways to address these mistakes, and this study seeks to provide recommendations in order improve diabetes care practices.},
     year = {2018}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment
    AU  - Wala’a Barifah
    AU  - Bill Davey
    AU  - Vince Bruno
    Y1  - 2018/06/21
    PY  - 2018
    N1  - https://doi.org/10.11648/j.sjph.20180603.15
    DO  - 10.11648/j.sjph.20180603.15
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 91
    EP  - 99
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20180603.15
    AB  - This study focuses on how parents make mistakes when administering insulin doses in treating hyperglycemia in their T1D diabetic children. This research employed a qualitative approach, conducting 58 semi-structured, in-depth interviews with 37 Saudi Arabian and Australian parents with T1D children, and 20 combined health professionals and company representatives. A conceptual tree analysis of the interviews was carried out using Atlas software. The initial coding was analyzed into two major themes: Misestimations and misunderstandings of insulin correction doses; and Mistakes in using injection tools and techniques. Each of these themes affords insight into correcting parents’ mistakes in insulin doses through a variety of techniques and technologies for T1D-related insulin delivery. In general, parents had made both corrected and uncorrected mistakes, and surprisingly, many were unfamiliar with the focal meaning of correction doses and how they are estimated or used. Despite significant efforts in diabetes education, the incidence of adverse health outcomes continues. This study shows that parental mistakes in insulin doses for treating hyperglycemia are crucial and involved issues. There are many ways to address these mistakes, and this study seeks to provide recommendations in order improve diabetes care practices.
    VL  - 6
    IS  - 3
    ER  - 

    Copy | Download

  • Sections