Parents' reflections on managing their children's diabetes with insulin pumps

Purpose: To describe the experiences of parents managing the type 1 diabetes of their young children using an insulin pump. Design: Qualitative description, based on principles of naturalistic inquiry. Methods: Open-ended, in-depth interviews were conducted with 21 mothers and fathers of 16 children less than 12 years old in the eastern part of the United States. The children had been on pump treatment from 3 to 36 months. Data were managed and analyzed using qualitative content analysis. Findings: Parents reported becoming comfortable with pump management 10 days to 2-3 months after the child started using it. During this adjustment period, they had to "rethink" how they managed the disease. Although using the pump required vigilance and more frequent glucose checking than did multiple daily injections (MDI), the pump provided better glucose control, easier disease management, fewer variables to manipulate, and more flexible meal times. A few parents were tempted to more tightly control the child's glucose levels, which could potentially increase parental stress. Fathers were actively involved in the day-to-day management and benefited from opportunities to participate in the child's care. They emphasized the importance of practicing the tasks associated with diabetes management to improve their confidence when caring for the child alone. Parents reported that everyone in the family experienced more freedom, flexibility, and spontaneity in their daily lives. Conclusions: For this sample of parents, the health and management benefits of their children's use of the insulin pump outweighed the adjustment challenges involved in changing from MDI.