Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting

Sze May Ng; Amphayvanh Manivong; Khamtavanh Khambuapha; Tyla Martin; Fiona Ooi; Steven James

doi:10.1136/bmjpo-2025-003924

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Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting

Journal article

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Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting

Sze May Ng, Amphayvanh Manivong, Khamtavanh Khambuapha, Tyla Martin, Fiona Ooi and Steven James

BMJ Paediatrics Open, Vol.10, pp.1-6

2026

DOI: https://doi.org/10.1136/bmjpo-2025-003924

PMID: 41617225

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Abstract

Laos

multiple daily injection (MDI)

type 1 diabetes (T1D)

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 Trust
Amphayvanh Manivong (Author) - Mahosot Hospital
Khamtavanh Khambuapha (Author) - University of Health Sciences Vientiane
Tyla 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
Organisation Unit: School of Health - Nursing
Language: English
Record Identifier: 991214273802621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Pediatrics

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