Navigating type 1 diabetes as a young couple: A qualitative analysis

Chronic Illness · 2026-02-09

ObjectivesType 1 diabetes (T1D) is a complex and chronic disease that often requires management within an interpersonal context. Young couples may face unique challenges as they integrate and negotiate diabetes routines into their lives. The purpose of this study is to examine the experiences of young adult couples as they adjust and adapt to the management of T1D in their relationship.MethodsYoung adults (25-40 years) living with T1D and their romantic partners (77 couples, 154 individuals) were separately interviewed. A constant comparison approach was used to qualitatively analyze the data for similarities and differences in perceptions of diabetes management as a dyad. Themes were then identified.ResultsThree themes emerged from the data: learning to incorporate diabetes into the relationship, working together to manage diabetes, and parenting with T1D. Young adult couples are developing coping mechanisms to manage diabetes together. Partners must learn to balance being supportive without being over controlling.DiscussionYoung adults with T1D and partners adjust to diabetes as a couple. Diabetes education for the partner is important to the relationship. Interventions developed to support couples establish collaboration earlier in their relationship may be beneficial for clinical and relationship outcomes.

Realigning diabetes regimens in older adults: a 4S Pathway to guide simplification and deprescribing strategies

The Lancet Diabetes & Endocrinology · 2025-02-17 · 24 citations

Family member involvement when multiple family members have type 1 diabetes

Diabetic Medicine · 2025-10-06

AIMS: Family involvement is beneficial for type 1 diabetes (T1D) self-management; however, few studies have examined family involvement when multiple family members (MFM) have T1D. This qualitative study examined the perceptions and experiences of family members (parents with and without diabetes, children with T1D, siblings without diabetes) where at least 2 members of the immediate family had T1D. MATERIALS AND METHODS: Semi-structured interviews were conducted with members from five families (N = 21). RESULTS: Qualitative themes emerged noting the benefits of having MFM with T1D for initial diagnosis and the enhanced cohesion that comes from the support MFM with T1D provide each other. Across families, even when a father had T1D and the mother did not, the mother was described as the key source of support for MFM with T1D. This increased mental load and responsibilities of mothers come with risks to mothers' physical and emotional well-being. Additionally, there were added family stressors, including enhanced financial burden, glucose levels interfering with family activities, and respecting differences among family members in management strategies. Finally, siblings without T1D noted frustrations and well-being concerns due to children with T1D being prioritized over them. CONCLUSIONS: The findings add a rich view of family involvement in families where MFM experience T1D, an important contribution to a literature focused nearly exclusively on families where only one person has T1D. Family members with and without T1D are providing substantial support that is largely quite effective. The findings have clear clinical implications, especially regarding the needed support for mothers, for financial support and for siblings without diabetes.

Development of a Diabetes Education Video Series in American Sign Language for Deaf and Hard of Hearing Populations

The Science of Diabetes Self-Management and Care · 2025-03-22 · 2 citations

ObjectiveThe purpose of the study was to describe the collaborative process of a deaf-hearing research team developing diabetes education videos in American Sign Language (ASL) for deaf and hard of hearing (DHH) populations.MethodsDiabetes education videos were guided by a DHH community advisory board (CAB) who were living with diabetes (N = 10), DHH video production team (N = 9), DHH research team members (N = 3), hearing clinical experts and research team members (N = 3), and a hearing designer (N = 1). Over 10 meetings, the CAB provided ongoing feedback to enhance video content and design. Videos were then developed using a rigorous 5-step process that involved script development, design of visual supports, script translation into ASL by native signers, video recording, and video editing. Interviews with individual CAB members were obtained to understand future video needs.ResultsUsing a design thinking and collaborative approach between deaf-hearing team members, 20 diabetes education videos were designed to prioritize ASL and DHH culture while still being inclusive for hearing family members who may not know ASL. The videos met the WebAIM guidelines for accessibility. CAB members rated the videos positively.ConclusionsThe diabetes education videos in ASL fill an existing void in diabetes education for DHH populations and are still being evaluated in the Deaf Diabetes Can Together intervention and will be placed on a future diabetes education website in ASL. This article highlights key details of developing diabetes education videos using a deaf-hearing team that future studies could learn from.

From Educators to Innovators: Part 2: Empowering the DCES as a Leader in Evidence-Based Quality Improvement

ADCES in Practice · 2025-08-31 · 1 citations

From Educators to Innovators: Part 1: The Case for Diabetes Care and Education Specialists in Clinical Inquiry

ADCES in Practice · 2025-06-19 · 1 citations

Diabetes Technology Accessibility in Deaf and Hard of Hearing People With Diabetes

Journal of Diabetes Research · 2025-01-01 · 1 citations

Background: Deaf and hard of hearing (DHH) populations face higher rates of diabetes and systemic barriers accessing diabetes technology. Effective use of diabetes technology relies on sensory (e.g., visual and audible) input and interpretation by the user. This study evaluates the accessibility of continuous glucose monitoring systems (CGMs) and insulin pumps for DHH individuals. Methods: A 2-h focus group was conducted to comprehensively evaluate the accessibility of two CGM and six insulin pumps in a sample of DHH individuals during an interactive, hands-on session. Participants used an investigator-developed 6-point Likert-like scale to score audible, haptic, and visual alarm features for each device and provided additional qualitative feedback that was captured. Observational field notes and team debriefing notes were analyzed using a thematic qualitative approach. Results: Nine diverse DHH participants living with diabetes consistently scored all devices as poor across each alarm feature. Median scores for audible, haptic and visual alarms for CGM were 2, 2.6, and 1.2 and for insulin pumps were 0.5, 2, and 0.7, respectively. The overall qualitative theme was that the evaluated diabetes technology devices were not designed to be accessible for DHH individuals. Participants noted that CGM and insulin pump companies fell short in providing audible, haptic, and visual alarms and provided several important recommendations. Conclusion: This study highlights the importance of diabetes technology companies including the creative and diverse perspectives of DHH people in diabetes technology design and testing to optimize accessibility. This inclusive approach fosters innovation by integrating universal design principles that can ultimately enhance the experience for all users.

Epidemiological and Clinical Insights into Enterovirus Circulation in Europe, 2018–2023: A Multicenter Retrospective Surveillance Study

The Journal of Infectious Diseases · 2025-04-03 · 19 citations

BACKGROUND: Enteroviruses (EV) cause yearly outbreaks with severe infections, particularly in young children. This study investigates EV circulation, age, and clinical presentations in Europe from 2018 to 2023. METHODS: Aggregated data were requested from the European Centre for Disease Prevention and Control National Focal Points for Surveillance and European Non-Polio Enterovirus Network. Data included detection month, specimen type, age group, and clinical presentation for the 10 most commonly reported EV types per year. RESULTS: Twenty-eight institutions (16 countries) reported 563 654 EV tests during the study period with 33 265 (5.9%) EV positive. Forty-two types were identified (n = 11 605 cases) with echovirus 30 (E30), coxsackievirus A6 (CVA6), EV-D68, E9, E11, CVB5, E18, CVB4, EV-A71, and E6 most frequently reported. E30 declined after 2018/2019, while CVA6, CVB5, E9, E11, and EV-D68 were prevalent both before and after the coronavirus disease 2019 (COVID-19) pandemic, and CVB4 and E18 were prevalent after the pandemic. A shift in seasons (summer to fall) and specimen positivity (feces to respiratory) was observed. Neurological signs predominated among EV-A71, CVB4, CVB5, E6, E9, E11, E18, and E30 (30%-72%). CVB4, CVB5, E9, E11, and E18 were frequently reported among neonates (18%-32%). CVA6 was frequently associated with hand, foot and mouth disease, and EV-D68 with respiratory infections. Paralysis was reported among 22 infections, associated with 10 nonpolio types. CONCLUSIONS: This study emphasizes the widespread circulation and severity of EV infections in Europe, as well as the (re)emergence of specific types postpandemic. Our findings highlight the need for continuous EV surveillance to monitor variation in circulation, age, and clinical presentations, including paralysis among nonpolio EV infections.

Insights on Improving Health Insurance Literacy in Diabetes

The Journal of Clinical Endocrinology & Metabolism · 2025-02-25 · 1 citations

CONTEXT: Many adults with diabetes cannot afford medications or health care and have low health insurance literacy, resulting in psychological distress and barriers to optimal self-management. OBJECTIVE: This mini-review aimed to explore the effectiveness of health-insurance literacy interventions and provide recommendations for diabetes practice. METHODS: We conducted a thorough search of relevant PubMed and Scopus studies from 2014 to 2024. Our inclusion criteria were interventions or pilot intervention studies using the search terms "health insurance" OR "health insurance literacy" OR "population (oncology, young adults/college/university students, and adults)." We then meticulously analyzed the quality of these studies, and assessments were conducted in Excel. We synthesized the evidence on interventions used to support health-insurance literacy across chronic health conditions and the general population, and their applications to diabetes care. Our findings showed effective interventions address a population's specific learning needs and literacy level. Multiple/diverse methods were used, including web-based decision aids, virtual sessions, hands-on support from navigators, Serious Games, educational workshops, and online microvideo Toolkits. Critical gaps included defining and measuring health-care literacy. CONCLUSION: Solutions for health-insurance education include strategies to incorporate education into academic curricula, diabetes transition programs, community health fairs, and employing community health workers within health-care systems. Although there is a validated health insurance literacy measure, consistent use of this measure across future programs can further the critically needed science in this field.

From Educators to Innovators: Part 3: Advancing Diabetes Care Through Research

ADCES in Practice · 2025-12-04