Exploring young people’s management of a dual diagnosis of Type 1 Diabetes and Coeliac Disease: a grounded theory study

Part One: Literature Review - Introduction: The current paper presents a systematic review of the evidence on the psychosocial impact of a dual diagnosis of Type 1 Diabetes (T1D) and Coeliac Disease (CD). Method: A systematic search of four databases was conducted. Results were screened and seven papers were included in the final review. Results: Findings from seven papers revealed equivocal results. Findings from four studies examining health-related quality of life (HRQoL) were contradictory and dependent upon the measures used to assess HRQoL. Two further studies identified an increased risk of depression and reduced social functioning in T1D and CD. Several methodological weaknesses were identified therefore findings should be interpreted with caution. Discussion: The current review highlights a paucity of rigorous research in this area. A greater understanding of the psychological impact of a dual diagnosis of T1D and CD is needed. Part Two: Research Report - Introduction: T1D and CD are both autoimmune conditions. Young people with T1D are at increased risk of developing CD. Little is known about young people’s experiences of managing a dual diagnosis of T1D and CD. The aim of the current study was to develop a model of how young people manage a dual diagnosis of T1D and CD. Method: Eight young people aged 11-16 years (six female, two male) were interviewed about their experiences of managing a dual diagnosis of T1D and CD. Interviews were transcribed and analysed using grounded theory. Results: A model of young people’s management of a dual diagnosis of T1D and CD was constructed with a central process of ‘feeling forced to stand out, and trying to fit in’. Three main categories of ‘people who help me’, ‘things I do’, and ‘just being myself’ comprised this process and were important factors in managing T1D and CD. Discussion: Findings highlighted the social impact of a dual diagnosis of T1D and CD. Clinical implications and further research are discussed. Part Three: Critical Appraisal - The critical appraisal presents a reflective account of the research process.