Journal article
Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting
BMJ Paediatrics Open, Vol.10, pp.1-6
2026
PMCID: PMC12863358
PMID: 41617225
Abstract
Background: Before 2016, no Laotian child was known to have survived type 1 diabetes (T1D) into adulthood. There is an ongoing need for action. Our study explored, in supported youth, the impact of transitioning from a twice to multiple daily injection (MDI) regimen on glycaemic control, and their views/perceptions around how the switch affected their T1D management/quality of life.
Methods: Data were obtained from medical records/semi-structured interviews; participants recruited as they switched to an MDI regimen. Quantitative data were stratified into glycated haemoglobin (HbA1c) 6/12 months before/after the switch, and male/female sex; associations examined using t-tests. Qualitative data were analysed using Gibb’s framework.
Results: Overall, 24 youth (62.5% female) changed regimens. Mean±SD HbA1c 6/12-month periods before the switch were 8.8±2.3% (73.0 mmol/mol)/8.3±2.2% (67.0 mmol/mol), respectively. In the same periods after the switch, HbA1c improved to 7.6±2.7% (60.0 mmol/mol)/7.7±2.1% (61.0 mmol/mol), respectively. No differences were observed between sexes.
Interviews were conducted with 15 youth (73.3% female); mean ages at T1D diagnosis/the switch time were 10.6 and 14.3 years, respectively. Describing how transitioning to an MDI regimen affected T1D management/quality of life, three themes emerged: pragmatism; empowerment and agency; and foundations of success.
Conclusions: The study provides valuable insights that will guide future work in supporting youth with T1D.
Details
- Title
- Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting
- Authors
- Sze May Ng (Corresponding Author) - Lancashire Teaching Hospitals NHS Foundation TrustAmphayvanh Manivong (Author) - Mahosot HospitalKhamtavanh Khambuapha (Author) - University of Health Sciences VientianeTyla Martin (Author) - Action4Diabetes (Thailand)Fiona Ooi (Author) - Action4Diabetes (Thailand)Steven James (Author) - University of the Sunshine Coast
- Publication details
- BMJ Paediatrics Open, Vol.10, pp.1-6
- Publisher
- BMJ Group
- Date published
- 2026
- DOI
- 10.1136/bmjpo-2025-003924
- ISSN
- 2399-9772
- PMID
- 41617225; PMC12863358
- Copyright note
- © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 991214273802621
- Output Type
- Journal article
Metrics
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- Domestic collaboration
- International collaboration
- Web Of Science research areas
- Pediatrics
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