18
ENGAGE
Coming of age
Research project seeks older Type 2s on insulin, an
update. By Susannah Hickling.
Researchers at King's College
London are stepping up
recruitment of older people
with Type 2 diabetes who
take insulin, or their carers, for a
study exploring their experiences.
Evidence of the experiences
of older people with insulin use
is limited. A systematic review
undertaken as part of the study
has revealed that psychological
aspects of using insulin (anxiety,
embarrassment) and physical factors,
such as the side effects of treatment
(potential hypoglycaemia) and
reaction to insulin administration,
are problematic for older people.
The researchers believe it
is important to gain a better
understanding of the challenges
they encounter in order to improve
services. "We are looking for people,
or their informal carers, who are
aged 70 or over, diagnosed with
Type 2 diabetes and have been on
insulin treatment for the past six to
48 months", says researcher Chaya
Langerman.
Type 2 diabetes is common in
older people, affecting approximately
20% of those aged 65-79 (94m
people) worldwide. Managing blood
glucose levels can be challenging
due to changes in physical function,
psychological health and cognitive
function. Older people may also
become more dependent on social
support to help them with their
diabetes self-management, including
taking medications, managing their
diet and monitoring blood glucose
levels.
Given the progressive nature of
diabetes, a significant proportion of
older people with Type 2 diabetes
require insulin therapy to help
regulate their blood glucose levels
and reduce the risks associated
with hyperglycaemia. But there
are often specific challenges in
the management of insulin and
using it safely in this age group,
including difficulty in administering
insulin accurately. Self-care can
increase the risk of poor adherence,
medication errors, hypoglycaemia
and hyperglycaemia.
When initiating insulin treatment
in older people, doctors should
consider any other health issues they
may have, the functional ability to
administer insulin and monitor blood
glucose, and appropriate treatment
goal-setting, as well as support for
their carers.
Reduce hazards
Gathering the experiences of insulin
treatment from older people and
their informal carers - such as
family, partners and close friends
- will inform the development of
new interventions in designing and
delivering services. These would aim
to reduce the hazards associated
with insulin use in this patient group
and support them more effectively.
The study is based on recorded
one-hour-long individual interviews,
which will take place over the
phone or face-to-face or virtually, if
possible, and be collated in a "trigger
film" (information film) to show to
clinicians, though participants are
under no obligation to be included in
the film.
Chaya Langerman stresses that
the interview will be straightforward
and the information gathered will
be anonymous. "It's a narrative
interview," she says. "There are no
challenging questions. Participants
tell me their experiences and I listen."
Those interested in participating
will receive an information pack
(covering letter, participant
information sheet, consent forms
for participation in the study and for
film release).
Participants will also receive a
£20 Love Shopping voucher, and any
travel expenses will be reimbursed.
To more information and to take
part, email
chaya.langerman@kcl.ac.uk
Chaya Langerman.
There are no
challenging
questions.
Participants
tell me their
experiences and
I listen