Exploring illness perceptions of a group of adolescents living with diabetes while using continuous glucose monitoring (CGM)

MA (Counselling Psychology), North-West University, Potchefstroom CampusType 1 diabetes (T1D) is regarded as one of the most rapidly growing chronic diseases globally, with an estimation that 1 in every 400 children diagnosed with diabetes mellitus every day (American Academy of Pediatrics, 2015). This diagnosis is accompanied by severe social, psychological, and behavioural consequences, especially during an already challenging developmental stage, as adolescents are expected to take more responsibility for their diabetes care plans. These young people develop a set of beliefs as part of making sense of their diagnosis, which directs them in the way they approach and manage their illness, and has been linked to their self-care management behaviours and treatment adherence outcomes. Only a few adolescents succeed in adequately controlling and managing their blood glucose levels as they confront multiple barriers in managing diabetes. Research studies to determine the psychological barriers and benefits that the use of continuous glucose monitoring systems holds, indicated that these systems form part of diabetes care plans. Yet there is a scarcity of research exploring the illness perceptions of adolescents living with diabetes within the South African context, let alone while they are using continuous glucose monitoring (CGM). This study aimed to breach this gap in research by exploring the illness perceptions of adolescents living with type 1 diabetes while they were using CGM. A qualitative approach was adopted and eligible participants were selected to participate in the study by using non-random purposive sampling as they had to meet clear predefined sample inclusion criteria. The selected population sample comprised of seven adolescents between the ages of 14 and 16 years living with type 1 diabetes mellitus and attending the Centre for Diabetes and Endocrinology (CDE) in Parktown, Johannesburg. Data were collected by semi-structured interviews, which lasted between 30 to 40 minutes. Data analysis was carried out by using Braun and Clarke’s thematic analysis. From the thematic analysis of each adolescent participant’s responses, three themes emerged: (1) CGM creates a sense of control over diabetes management; (2) CGM assists in creating a new normal; and (3) being different creates an opportunity for positive outcomes. From the findings it became evident that adolescents perceive diabetes management as challenging because it imposes barriers which inhibit them from living a so-called normal life. Nonetheless, it was apparent that, since using CGM, they regarded diabetes management as more convenient and manageable as they experienced an increased sense of control both over diagnosis and management. The continuous visibility of their blood glucose levels promoted predictability, allowing participants to experience their diabetes management as a positive experience that assisted them in feeling more normal in relation to their peers. Feeling in control of the diagnosis and the care plans that accompanied it empowered participants to ultimately accept the condition and its management with a newfound confidence for the future. In conclusion, fresh insight is obtained into the illness perceptions of adolescents living with type 1 diabetes who are using CGM in the South African context. The findings could be beneficial to diabetes health care providers, caregivers of adolescents living with diabetes, or patients themselves. New insights may assist in broadening the understanding of the use of CGM devices and their impact on illness perceptions. With greater knowledge, adolescents living with diabetes may experience these diabetes care plans as more manageable. Through perceiving a greater sense of control over the diabetes care plans, adolescents living with diabetes may be able to identify a silver lining in the manageability of their diagnosis which may have been previously overlooked.Master