ORIGINAL ARTICLE   

Minerva Endocrinologica 2019 December;44(4):336-43

DOI: 10.23736/S0391-1977.19.03024-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Coping strategies in people with type 1 diabetes on insulin pump treatment

Alessandro BISIO ¹ ✉, Elena GAMARRA ², Fabio BROGLIO ², Giorgio GRASSI ²

¹ Berkeley Center for Social Medicine, University of California, Berkeley, CA, USA; ² Unit of Endocrinology, Diabetology and Metabolism, San Giovanni Antica Sede Hospital, Città della Salute e della Scienza, Turin, Italy

BACKGROUND: In stressed people with diabetes (PWD) glycemia varies idiosyncratically. Coping is a relatively stable personality trait that assesses how individual deals with stress. Insulin pumps are considered the best insulin delivery system but require more attention from PWD, virtually increasing stress levels. Aim of our study was to evaluate the coping strategies adopted by a pool of participants with type 1 diabetes mellitus (T1DM) on continuous subcutaneous insulin infusion (CSII) therapy.
METHODS: We collected data from 158 people with T1DM on CSII. COPE-NVI Test was administered and we also collected: hemoglobin A1c (HbA1c), 30 days of self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM) records (the most recent). From SMBG and CGM records we computed Kovatchev indexes. We investigated bivariate correlations between HbA1c, indexes and the results of the COPE-NVI Test; the analysis was performed on the total sample and on two sub-groups: men and women. The participants were then divided into clusters and non-parametric tests were performed.
RESULTS: Regarding bivariate correlation, at a level of significance of 95%, several statistically significant correlations were found in the total sample and in both men and women sub-groups. Regarding non-parametric tests, we observed statistically significant results in clusters of the total sample and clusters of the sub-group formed by men, divided according to Low Blood Glucose Index (LBGI) risk, showing a different use of certain coping strategies.
CONCLUSIONS: Assessing coping strategies preferably used by PWD is useful to select PWD in need of counseling and empowerment-oriented training in order to improve glycemic outcomes and decrease severe hypo/hyperglycemic events.

KEY WORDS: Diabetes mellitus, type 1; Insulin infusion systems; Adaptation, psychological