International Diabetes Nursing

Type 1 diabetes and menopause, what women would like to know: a public and patient involvement exercise

Rita Forde, Lisa King, Anne Cooper, Kirsty Winkley, Vivien Coates — Fri, 12 Apr 2024 00:00:00 -0700

Introduction: Managing the impacts of the menopause can be a tedious experience for many women, and when coupled with diabetes, the challenges are multiplied. Literature searches confirm a dearth of information and support to help women with these dual conditions.

Methods: A Patient Public Involvement exercise involving an online survey disseminated electronically via social media amongst the Type 1 diabetes online community. It comprised five closed questions and one open question to elicit priority needs. The survey was supplemented with a subsequent Twitter chat. The paper conforms to the guidance for reporting of patient and public involvement in health and social care research (GRIPP).

Results: Of the 184 women who completed the survey across the United Kingdom, most were aged between 40 and 59 years (n = 167, 90.8%). Although 137 (72.8%) women reported that menopause had impacted on their diabetes, only a minority (n = 50, 27.2%) indicated that it had ever been discussed with them. The overarching theme from the open question was of an overall Lack of awareness about the impacts of menopause, with the following subthemes: 1) Need for information about menopause, 2) An additional burden, 3) Symptoms of diabetes or menopause? and 4) Communication – expectations of care.

Conclusions: Women need information, support and guidance during this phase of life. This oft overlooked aspect of care is engendering frustration and suboptimal diabetes management and will be a topic raised with increasing frequency in general practice and diabetes specialities. The management of diabetes and menopause deserves more attention across the diabetes community.

Tailored care by diabetes nurses is not enough to overcome disparities in the regulation of type 2 diabetes between Dutch natives and ethnic minority groups

Fri, 12 Apr 2024 00:00:00 -0700

Background: Differences in diabetes regulation between patients from different ethnic background have been described. This may be reduced by regular visits to a diabetes nurse (RVDN) with the same mother tongue. We explored whether equal access to diabetes-related care, including RVDN with the same mother tongue, may result in similar diabetes regulation among ethnic minorities and Dutch natives.

Methods: Patients with type 2 diabetes and an annual comprehensive diabetes evaluation were included in this study. For the analysis, we emphasized on the data of patients with RVDN and used descriptive statistics and nonparametric tests for between group comparisons.

Results: From a total of 983 patients, 581 patients had RVDN of whom 266 (46%) Dutch natives, 199 (34%) Turks/Moroccans, and 116 (20%) patients from other ethnicities. Within the group of patients with RVDN, Turks/Moroccans had higher median fasting plasma glucose levels as compared with Dutch natives and other ethnic minorities (8.4 vs 7.9 and 7.3 mmol/L, P < 0.001), and a higher HbA1c level was found for both the Turks/Moroccans and other ethnic minorities, as compared to Dutch natives (62 vs 55 mmol/mol, P < 0.001). In addition, only 22% of Turks/Moroccans and 26% of other minorities achieved the American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD)-recommended HbA1c target ≤53 mmol/mol, compared to 39% in Dutch natives.

Conclusions: In patients with RVDN with the same mother tongue, we still found disparities in HbA1c levels between Dutch natives, Turks/Moroccans and other ethnic minorities. Other factors beyond Dutch language skills are likely to interfere.