Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?

Steven James; Kylie Annetts; Thuy Frakking; Marc Broadbent; John Waugh; Lin Perry; Julia Lowe; Sean Clark

doi:10.1186/s12913-021-06715-7

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Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?

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Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?

Steven James, Kylie Annetts, Thuy Frakking, Marc Broadbent, John Waugh, Lin Perry, Julia Lowe and Sean Clark

BMC Health Services Research, Vol.21(1), pp.1-8

2021

DOI: https://doi.org/10.1186/s12913-021-06715-7

PMCID: PMC8272902

PMID: 34246266

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Abstract

Continuous glucose monitoring

Diabetes mellitus, type 1

Diabetes services

Diabetic ketoacidosis

Healthcare professionals

Research

Socio-economic

Support

Telephone

Type 1 diabetes

Background: Diabetic ketoacidosis causes a significant number of hospitalisations worldwide, with rates tending to increase with remoteness and socioeconomic disadvantage. Our study aimed to explore healthcare professionals’ perceptions of factors affecting presentation of people with type 1 diabetes in a low socioeconomic area of Queensland, Australia. Methods: This was a qualitative study. Individual semi-structured face-to-face or telephone interviews were completed with patients with type 1 diabetes who had presented in diabetic ketoacidosis, and healthcare professionals who have experience in related care. Data were analysed using Gibbs’s framework of thematic analysis. Results: Four patients with type 1 diabetes and 18 healthcare professionals were interviewed. Restricted access was identified as a factor contributing to diabetic ketoacidosis and delayed presentation, with ketone testing supplies, continuous glucose monitoring technology and transport considered barriers. Many of these factors were arguably preventable. Opportunities to improve the care available to patients with type 1 diabetes were detailed, with particularly strong support for dedicated out of hours telephone help lines for adults with type 1 diabetes. Conclusions: Gaps in support for patient self-care to avoid diabetic ketoacidosis presentations and prevent late presentation of diabetic ketoacidosis revealed by this study require service reconfiguration to support care delivery. Until change is made, people with type 1 diabetes will continue to make both avoidable and delayed, acutely unwell, presentations to Emergency Departments.

Details

Title: Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?
Authors: Steven James (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - Legacy
Kylie Annetts (Author) - Caboolture Hospital (Australia)
Thuy Frakking (Author) - The University of Queensland
Marc Broadbent (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - Legacy
John Waugh (Author) - Caboolture Hospital (Australia)
Lin Perry (Author) - University of Technology Sydney
Julia Lowe (Author) - University of Newcastle Australia
Sean Clark (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - Legacy
Publication details: BMC Health Services Research, Vol.21(1), pp.1-8
Publisher: BioMed Central Ltd.
Date published: 2021
DOI: 10.1186/s12913-021-06715-7
ISSN: 1472-6963
PMID: 34246266; PMC8272902
Copyright note: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Organisation Unit: School of Health - Nursing; University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
Language: English
Record Identifier: 99569207802621
Output Type: Journal article

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