The impact of insulin pump use on body image and emotional state in adolescents with type 1 diabetes

BACKGROUND: Type 1 diabetes (T1DM) is one of the most common chronic diseases in children and adolescents, and is on the increase. The treatment for T1DM is insulin, either by multiple daily injections or by pump. Glycemic control is improved with the use of an insulin pump. In the Western world, patients are increasingly treated with external insulin pumps. Adolescents with T1DM have more psychological difficulties, such as anxiety and depression, than the general population. The body image of adolescents with T1DM is impacted by somatic damage and treatments. More specifically, the insulin pump has an impact on body image, notably through its visibility, heaviness, and contact with the skin. OBJECTIVE: To study the impact of external insulin pump treatment versus multiple injections (MDI) on the body image of adolescents with T1DM. MATERIALS AND METHODS: This was a single-center, cross-sectional, mixed-method study, using standardized tests and semi-structured interviews, leading to quantitative and qualitative results. RESULTS: Forty-two patients with T1DM aged between 12 and 20, 22 of whom were treated with insulin pumps (PP patients) and 20 with daily injections (MDI patients). Body image was affected by the higher body mass index (BMI) of PP patients and by the insulin pump itself, due to the often negative body sensations generated in adolescents. Adolescents with T1DM have more psychological difficulties than patients without somatic pathology. There are more depressive symptoms in MDI patients and more anxiety in PP patients. CONCLUSION: The insulin pump has a negative impact on the body image of adolescent patients.