Stereotypical ideas of the attributes a person with diabetes needs to have in order to use an insulin pump successfully are not always founded, research shows.
The UK study involving in-depth interviews with 18 DAFNE trained diabetes specialists and dietitians revealed that diabetes teams often used ‘tacit and informal’ criteria to decide whether individuals had the “right” personal and psychological attributes to use a pump effectively.
For instance some of the diabetes health professionals interviewed admitted not recommending pump therapy to “troublesome and heart sink” patients who “have always had poor control, poor compliance” or who “might expect a pump to do all the work”.
Older people were also frequently perceived as poor candidates for pump therapy, reported the research team led by Julia Lawton from the University of Edinburgh in Diabetic Medicine.
Conversely, patients who were “more technically able” and “more intelligent” were deemed as suitable candidates.
But exposing the diabetes health professionals to people they would have not recommended for pump therapy in routine clinical practice forced them to examine the informal criteria they used to predict potential success, the study showed.
After becoming involved in the REPOSE trial that randomised patients to pump therapy one respondent said: “I have a lady, she’s 72, she came and her first comment to me bless her was, you know, ‘I can’t text. Can’t text.’ And she’s doing really well… So I’ve stopped having preconceptions about who it will suit”.
“Some of the ones who you think are good with the mechanics of the pump and everything, you think, ‘oh they will pick it up very quick’ but, actually, it’s too quick and they go off and do all their own, ” another said.