Stream	Abstract - Living with Diabetes
Topic	Type 1 diabetes
Abstract title	Experiences of adults about Insulin Pump Therapy and its effect on quality of life and glycemic control in Kuwait
Co-authors	N. Mesbah1, Z. Rahme1, N. Taha1, D. Omar2, F. Sukkar1.
1Dasman Diabetes Institute, Education & Training, Kuwait City, Kuwait.
2Dasman Diabetes Institute, Family Medicine & Pediatric Unit, Kuwait City, Kuwait.
Abstract body	Background
Management of type 1 diabetes can be challenging and difficult as complex skills are required to enable the individual to achieve euglycaemia while avoiding extensive periods of hyperglycaemia. Diabetes Control and Complications Trial (DCCT) findings made it clear that targting a glycosylated hemoglobin (HbA1C) of less than 7%, will help in preventing or delaying the long-term diabetes complications. Tight glycemic control can be accomplished through intensive insulin therapy by multiple daily injections or via insulin pump therapy. The benefits of tight glycemic control have increased interest in technologies that might facilitate intensive therapy to achieve euglycaemia but without increasing the risk of hypoglycemia or weight gain.
Insulin pump therapy has been shown to be effective and safe alternative to multiple daily injections of insulin in all age groups of patients with type 1 diabetes. Moreover, innovation of insulin pump was designed to improve both glycemic control and at the same time the quality of life (QoL) of people with type 1 diabetes. Furthermore, the delivery of insulin via the pump system is so flexible that it allows the health care providers or insulin pump users to adjust the insulin delivery rate whenever it is necessary. It mimics the physiological pattern of insulin secretion of the pancreas in people without diabetes. Although insulin pump therapy has recently started to be used more widely in Kuwait, its effectiveness and benefit has not been investigated and are still unclear. Healthcare providers and their diabetic patients need more information when making decisions to initiate this type of therapy.
Aim
Exploring Kuwaiti adults’ perceptions and experiences towards insulin pump therapy and its effect on their quality of life and glycemic control’: a qualitative study. This study aimed to explore the Kuwaiti adults’ perceptions and experiences towards insulin pump therapy and its effect on their quality of life and glycaemic control. (i) To explore the experiences of Kuwaiti adults on the use of insulin pump therapy, in the context of their quality of life. (ii) To gain in-depth understanding of the perceptions of Kuwaiti adults with type 1 diabetes about insulin pump therapy and its use for diabetes management.
Method
Eight Kuwaiti adults with type 1 diabetes; (50% males and 50% females, aged 34.0 ± 8.4, insulin pump therapy duration 4.18 ± 2.82), were recruited from adult insulin pump clinic at Dasman Diabetes Institute. Each participant was individually interviewed by the interviewer using the topic guide. The in-depth interview helped to explore the impact of insulin pump therapy on the participants regarding the therapy benefits, effectiveness and disadvantages from their viewpoint.
Results
The thematic analysis of the transcripts led to the detection of six main themes: ‘Health Benefits’, ‘Lifestyle Flexibility’, ‘Mood and Emotion Improvement’, ‘Practical Trouble’, ‘Physical & Personal Influence’ and ‘Self-Confidence of Managing Diabetes’. 
An overview of five main themes and corresponding sub-themes emerging from the data are presented in table.
Main Themes 	Sub-themes 
Health Benefits 	•	· Better glycemic control
•	· Reduction in hypoglycemia attacks
•	· Reduction in hypoglycemia severity
•	· Reduction in glucose variability
•	· Reduction in hospital admission 
•	· Reduction in omitting insulin doses
Lifestyle flexibility 	•	· Flexibility of eating
•	· Flexibility of exercise
•	· Better quality of sleep
•	· Flexibility of social & work life
•	· Enabling fasting Ramadan
•	· Flexibility during travelling 
Mood and emotion improvement 	•	· Less frequent injections
•	· Better glycemic control
•	· Better relationship with healthcare team
•	· Less worry about the complications
•	· Less arguing with family members 
•	· Less worry of forgetting insulin
Practical trouble 	•	· Fear of pump malfunction
•	· Fear of kinked cannula
•	· Fear of air bubbles
•	· Fear with Alarms 
Physical & Personal influence 	•	· Less pain 
•	· Less lumps & scars
•	· Fear of getting local reactions
•	· Pump visibility
•	· Less freedom in clothes choices 
Self-Confidence of managing diabetes 	•	· Gaining knowledge 
•	· Applying information
•	· Problem solving 
•	· Less dependent 
Discussion
There was general conformity among participants that the insulin pump therapy had positively affected their QoL; they reported that the benefits of insulin pump therapy did overcome its disadvantages. The main positive change was centered on enhanced flexibility and lifestyle regarding many aspects such as; glycaemic control, eating times, food selection and exercise. Altogether, these themes notify us of the complexity of the participants’ experiences and the impact that the insulin pump therapy has had on several aspects of their lives. 
Conflict of Interest	I have no potential conflict of interest to disclose