{
  "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.",
  "authors": [
    {
      "affiliations": [
        "Edge Hill University, Ormskirk, UK",
        "Mersey and West Lancashire Teaching Hospitals, Ormskirk, UK"
      ],
      "name": "Sze May Ng"
    },
    {
      "affiliations": [
        "Mahosot Hospital, Vientiane, Lao People’s Democratic Republic"
      ],
      "name": "Amphayvanh Manivong"
    },
    {
      "affiliations": [
        "University of Health Sciences, Vientiane, Lao People’s Democratic Republic"
      ],
      "name": "Khamtavanh Khambuapha"
    },
    {
      "affiliations": [
        "Action4Diabetes, Bangkok, Thailand"
      ],
      "name": "Tyla Martin"
    },
    {
      "affiliations": [
        "Action4Diabetes, Bangkok, Thailand"
      ],
      "name": "Fiona Ooi"
    },
    {
      "affiliations": [
        "University of the Sunshine Coast, Petrie, Queensland, Australia",
        "University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Steven James"
    }
  ],
  "title": "Voices from Laos: navigating the transition from a twice daily to multiple daily insulin regimen in a resource-limited setting",
  "uid": "a840c761-7bfa-54e4-85a5-f24a7eb04617"
}