Article| Volume 37, ISSUE 1, P48-55, January 2023

Type 1 Diabetes Management and Health Care Experiences Across Rural Nebraska

Published:September 02, 2022DOI:


      • Families living in rural Nebraska experienced decreased health care access.
      • Geographic and social isolation cause dramatic lifestyle changes after a child's T1D diagnosis.
      • Technology improved diabetes management and access to care.
      • Interprofessional teams may provide novel health care delivery systems to increase access and decrease health care disparities.



      This study aimed to explore the unique health care needs of rural Nebraska families with a child with type 1 diabetes mellitus (T1DM).


      Using a phenomenological approach, the researchers conducted four focus groups across Nebraska. The focus groups gathered input from children, caregivers, and health care providers (n = 23). The researchers coded data and generated themes. Member checking, researcher triangulation, reflexivity, a thick description of the process, and an audit trail established trustworthiness.


      Four themes emerged: dramatic family and lifestyle changes following diagnosis, lack of access to specialized care resulting in complications, isolation improved health management resourcefulness, and technology improved health management and flexibility.


      Lifestyle changes persist after a child's diagnosis with T1DM. Rural families reported unpredictable health status of their child, reduced health care services, and limited information access. Conversely, limited specialty health care access, resources, and community support led to creative self-education, advocacy, and health care management strategies. Diabetes technology offered opportunities for improved provider-patient communication and continuous glucose monitoring.


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