Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY)

Natalie Zaremba¹, Glenn Robert², Jacqueline Allan¹, Amy Harrison^{1

3

4}, Jennie Brown^{1

5}, Emmanouela Konstantara¹, Miranda Rosenthal⁶, Divina Pillay⁷, Anita Beckwith⁵, Janet Treasure⁸, David Hopkins⁹, Khalida Ismail¹⁰, Marietta Stadler^{1

10}

Affiliations

¹ Department of Diabetes, Faculty of Life Sciences and Medicine, King's College London, London, UK.
² Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
³ Department of Psychological Medicine, King's College London, London, UK.
⁴ Department of Psychology and Human Development, University College London, Institute of Psychiatry, London, UK.
⁵ Diabetes Centre, King's College Hospital, London, UK.
⁶ Diabetes Centre, Royal Free Hospital, London, UK.
⁷ St Vincent Square Eating Disorder Unit, Chelsea and Westminster NHS Foundation Trust, London, UK.
⁸ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Institute of Diabetes Endocrinology and Obesity, King's Health Partners, London, UK.
¹⁰ Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK.

PMID: 34821402
DOI: 10.1111/dme.14749

Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY)

Natalie Zaremba et al. Diabet Med. 2022 Apr.

. 2022 Apr;39(4):e14749.

doi: 10.1111/dme.14749. Epub 2021 Dec 23.

Authors

Affiliations

¹ Department of Diabetes, Faculty of Life Sciences and Medicine, King's College London, London, UK.
² Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
³ Department of Psychological Medicine, King's College London, London, UK.
⁴ Department of Psychology and Human Development, University College London, Institute of Psychiatry, London, UK.
⁵ Diabetes Centre, King's College Hospital, London, UK.
⁶ Diabetes Centre, Royal Free Hospital, London, UK.
⁷ St Vincent Square Eating Disorder Unit, Chelsea and Westminster NHS Foundation Trust, London, UK.
⁸ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Institute of Diabetes Endocrinology and Obesity, King's Health Partners, London, UK.
¹⁰ Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK.

PMID: 34821402
DOI: 10.1111/dme.14749

Abstract

Aims: To develop a cognitive behavioural therapy-based intervention for people with type 1 diabetes and disordered eating using Experience-Based Co-Design as part of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY).

Methods: Fifteen people with type 1 diabetes and experience of disordered eating (33 ± 11 years old, 22 ± 12 years diabetes duration) and 25 healthcare professionals working in type 1 diabetes or eating disorders (44 ± 9 years old; 14 ± 10 years of professional experience) attended six Experience-Based Co-Design workshops from July 2019 to March 2020 to collaboratively develop intervention content.

Results: We developed a cognitive behaviour therapy intervention 'toolkit' that can be tailored for individual patient needs. Participants designed and revised toolkit materials to ensure acceptability and relevance for people with diabetes and disordered eating by engaging in guided discussion, brainstorming, and rapid testing to review toolkit prototypes in an iterative process. Workshop themes were 'Insulin titration'; 'Hypoglycaemia'; 'Coming to terms with diabetes'; 'Fear of weight gain'; 'Toolkit revision'; and 'Practical elements of STEADY therapy'. The intervention is focussed on improving diabetes self-care and embedded in a multidisciplinary healthcare approach. The intervention will be delivered in 12 sessions by a diabetes specialist nurse trained in cognitive behavioural therapy.

Conclusions: Through an iterative co-design process, people with type 1 diabetes and healthcare professionals collaboratively developed a novel intervention toolkit that can be used with a wide range of disordered eating presentations. The intervention will be tested in the STEADY feasibility randomised controlled trial.

Keywords: cognitive behaviour therapy; eating disorder; experience-based co-design; intervention; participatory action research; qualitative; type 1 diabetes mellitus.

PubMed Disclaimer

References

REFERENCES

1. Allan J. Understanding poor outcomes in women with type 1 diabetes and eating disorders. J Diabetes Nurs. 2015;19:99-103.
1. Merwin RM, Dmitrieva NO, Honeycutt LK, et al. Momentary predictors of insulin restriction among adults with type 1 diabetes and eating disorder symptomatology. Diabetes Care. 2015;38(11):2025-2032. doi:10.2337/dc15-0753
1. Vallis M, Jones A, Pouwer F. Managing hypoglycemia in diabetes may be more fear management than glucose management: a practical guide for diabetes care providers. Curr Diabetes Rev. 2014;10(6):364-370.
1. Feltbower RG, Bodansky HJ, Patterson CC, et al. Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults. Diabetes Care. 2008;31(5):922-926. doi:10.2337/dc07-2029
1. Goebel-Fabbri AE, Fikkan J, Franko DL, Pearson K, Anderson BJ, Weinger K. Insulin restriction and associated morbidity and mortality in women with type 1 diabetes. Diabetes Care. 2008;31(3):415-419. doi:10.2337/dc07-2026

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- Ovid Technologies, Inc.
- Wiley
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY)

Affiliations

Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY)

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical