'I don't feel like a diabetic any more': the impact of stopping insulin in patients with maturity onset diabetes of the young following genetic testing.

2.50
Hdl Handle:
http://hdl.handle.net/11287/619264
Title:
'I don't feel like a diabetic any more': the impact of stopping insulin in patients with maturity onset diabetes of the young following genetic testing.
Authors:
Shepherd, Maggie ( 0000-0003-2660-0955 ) ; Hattersley, Andrew T.
Abstract:
Hepatocyte nuclear factor-1alpha (HNF-1alpha) maturity onset diabetes of the young (MODY) is the commonest cause of monogenic diabetes but is frequently misdiagnosed as type 1 diabetes. The availability of genetic testing in MODY has improved diagnosis. Sulphonylurea sensitivity in HNF-1alpha patients means that those on insulin from diagnosis can transfer to sulphonylureas and may improve glycaemic control. To gain insight into the implications for patients of stopping insulin, in-depth interviews were conducted with eight HNF-1alpha patients transferred to sulphonylureas after a median of 20 years on insulin. Thematic content analysis highlighted four key themes: Fear, anxiety and excitement regarding stopping insulin, particularly among those who had been on insulin for many years or had never omitted insulin in the past. Improved lifestyle and self image accompanied by feelings of relief and 'increased normality'. Reflections on their time on insulin, including feelings of annoyance, particularly when the need for insulin treatment had been questioned at diagnosis. Difficulty 'letting go' of insulin treatment--some patients found it hard to believe that they no longer required injections as this conflicted with messages previously received from healthcare professionals. Transferring from insulin to sulphonylureas had a positive impact on lifestyle but support was needed for patients to adjust, many having grown up with the belief they would be on insulin for life.
Citation:
'I don't feel like a diabetic any more': the impact of stopping insulin in patients with maturity onset diabetes of the young following genetic testing., 4 (2):144-7 Clin Med (Lond)
Publisher:
Royal College of Physicians
Journal:
Clinical medicine (London, England)
Issue Date:
2-Sep-2016
URI:
http://hdl.handle.net/11287/619264
PubMed ID:
15139733
Additional Links:
http://www.clinmed.rcpjournal.org/content/4/2/144.long
Note:
RD&E staff can access the full-text of this article via OpenAthens. Click on the 'Additional Link' above to access the full-text and log in with NHS OpenAthens if prompted.
Type:
Research Support, Non-U.S. Gov't
Language:
en
ISSN:
1470-2118
Appears in Collections:
pre-2014 RD&E publications; Diabetes/Endocrine Services; Clinical Genetics (Peninsula Genetics)

Full metadata record

DC FieldValue Language
dc.contributor.authorShepherd, Maggieen
dc.contributor.authorHattersley, Andrew T.en
dc.date.accessioned2016-09-02T09:20:08Z-
dc.date.available2016-09-02T09:20:08Z-
dc.date.issued2016-09-02-
dc.identifier.citation'I don't feel like a diabetic any more': the impact of stopping insulin in patients with maturity onset diabetes of the young following genetic testing., 4 (2):144-7 Clin Med (Lond)en
dc.identifier.issn1470-2118-
dc.identifier.pmid15139733-
dc.identifier.urihttp://hdl.handle.net/11287/619264-
dc.description.abstractHepatocyte nuclear factor-1alpha (HNF-1alpha) maturity onset diabetes of the young (MODY) is the commonest cause of monogenic diabetes but is frequently misdiagnosed as type 1 diabetes. The availability of genetic testing in MODY has improved diagnosis. Sulphonylurea sensitivity in HNF-1alpha patients means that those on insulin from diagnosis can transfer to sulphonylureas and may improve glycaemic control. To gain insight into the implications for patients of stopping insulin, in-depth interviews were conducted with eight HNF-1alpha patients transferred to sulphonylureas after a median of 20 years on insulin. Thematic content analysis highlighted four key themes: Fear, anxiety and excitement regarding stopping insulin, particularly among those who had been on insulin for many years or had never omitted insulin in the past. Improved lifestyle and self image accompanied by feelings of relief and 'increased normality'. Reflections on their time on insulin, including feelings of annoyance, particularly when the need for insulin treatment had been questioned at diagnosis. Difficulty 'letting go' of insulin treatment--some patients found it hard to believe that they no longer required injections as this conflicted with messages previously received from healthcare professionals. Transferring from insulin to sulphonylureas had a positive impact on lifestyle but support was needed for patients to adjust, many having grown up with the belief they would be on insulin for life.en
dc.language.isoenen
dc.publisherRoyal College of Physiciansen
dc.relation.urlhttp://www.clinmed.rcpjournal.org/content/4/2/144.longen
dc.rightsArchived with thanks to Clinical medicine (London, England)en
dc.subjectWessex Classification Subject Headings::Endocrinology::Diabetesen
dc.title'I don't feel like a diabetic any more': the impact of stopping insulin in patients with maturity onset diabetes of the young following genetic testing.en
dc.typeResearch Support, Non-U.S. Gov'ten
dc.identifier.journalClinical medicine (London, England)en
dc.description.noteRD&E staff can access the full-text of this article via OpenAthens. Click on the 'Additional Link' above to access the full-text and log in with NHS OpenAthens if prompted.en
dc.type.versionPublisheden

Related articles on PubMed

All Items in RD&E Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.