Piloting a Culturally Adapted Arabic Structured Small-Group Education Program for Adolescents with Type 1 Diabetes.

BACKGROUND: Kuwait has a high prevalence and incidence of type 1 diabetes (T1D). At present there is a need for structured educational programs (SEP) specifically tailored for Arabian youth with T1D. This SEP was locally and culturally adapted from the Kids In Control of Food (KICk-OFF) course delivered at the Dasman Diabetes Institute, Kuwait. AIMS: To explore the psychological and social impact of a pilot SEP for Arabian youth with T1D and their mothers through exploring their respective perspectives. METHODS: All 20 participants were interviewed using semistructured interviews individually, with a duration of approximately 30-45 min. The interviews were recorded and then transcribed verbatim. Data were analyzed using an inductive thematic approach. RESULTS: The adolescents gained more self-confidence in managing their diabetes and their mothers were more confident in allowing their children take the lead in their diabetes self-management. Participants were empowered with adequate knowledge about the underlying pathophysiology of glucose metabolism and the nutritional and pharmacological management which made them feel in control and helped them to better cope with diabetes. It reduced diabetes-related family stress and gave them more social freedom, supporting behavioral change for a better lifestyle. CONCLUSIONS: Attending the adapted SEP had a positive impact on adolescents with T1D and their mothers through enhancement of their knowledge and confidence, thus giving them a sense of disease control. This pilot study has proven effective in terms of enhancement of confidence in diabetes management and psychosocial factors. Therefore, there is a need for a wider implementation.

Experiences of Adults Using Continuous Subcutaneous Insulin Infusion: A Qualitative Study.

OBJECTIVES: We aimed to determine the quality of life (QoL) of Kuwaiti adults with type 1 diabetes mellitus (T1DM) who used continuous subcutaneous insulin infusions (CSIIs) and to understand their perception of this treatment. BACKGROUND: CSII is an effective and safe alternative to multiple daily injections for T1DM, with the potential to improve both glycemic control and QoL. Although CSII has been widely used in Kuwait, its effectiveness and benefits have not been properly evaluated. Healthcare providers and patients need more information on CSII before its initiation. METHODS: In this qualitative case study, semi-structured individual interviews were performed using a topic guide. Interviews were stopped at data saturation point. Subsequently, a thematic analysis of transcripts was performed. RESULTS: Eighteen adults with T1DM (8 males and 10 females; age 31.4 ± 6.4 years; diabetes duration 17.7 ± 9.5 years; CSII duration 3.6 ± 2.4 years) were recruited from the CSII clinic. Six main themes were studied: health benefits, lifestyle flexibility, improvement of mood and emotion, practical problems, physical and personal effects, and self-confidence to manage diabetes. CSII positively affected the QoL of participants', most notably by enhancing lifestyle flexibility; however, important negative qualities were also reported. CONCLUSION: The identified themes highlight the complexity of the experiences of participants, and can be used to provide a framework to help healthcare providers understand how people with T1DM become aware of their treatment regimens. It is important to identify the positive aspects of CSII and not focus only on its negative effects.

Evaluation of the impact of a diabetes education eLearning program for school personnel on diabetes knowledge, knowledge retention and confidence in caring for students with diabetes.

AIMS: To study the impact of a novel comprehensive eLearning approach in delivering diabetes related education program that includes knowledge and sets of practices to the school personnel in Kuwait to enable them to provide a supportive environment for students with diabetes. METHODS: The program was designed with three components namely; knowledge, skills and recommendations. The diabetes knowledge was delivered through an interactive eLearning program, the effectiveness of which was assessed using diabetes knowledge questionnaires which were deployed pre- and post-course delivery. Additionally, the participants' knowledge retention and confidence in caring for a student with diabetes were evaluated at 6 or 12 months post-intervention. RESULTS: A total of 124 public schools' personnel participated in the program. Post e-Learning delivery, diabetes knowledge increased significantly from baseline (p < 0.0001) and knowledge was retained over 6 and 12 months. Average of overall confidence scores in caring for students with diabetes was 61.86% in all items of care. CONCLUSIONS: Offering eLearning diabetes education for school personnel increases their knowledge which can be retained for up to 12 months and imparts confidence in caring for students with diabetes. This novel approach of delivering diabetes education will help school personnel in managing students with diabetes.