Evidence map›Paper›PMID 40196455›Full record

ArticleFrontiers in endocrinology2025

"Can I afford to live today?" The emotional toll of navigating the healthcare system with type 1 diabetes.

Shiraz Harel, James Lukasik, Annabelle Wilcox, Kasia J Lipska, Stuart A Weinzimer, Sakinah C Suttiratana, Laura M Nally

Abstract read
In one paragraph

Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shiraz HarelDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United States.
James LukasikDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United States.
Annabelle WilcoxBryn Mawr College, Bryn Mawr, PA, United States.
Kasia J LipskaSection of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Stuart A WeinzimerDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United States.
Sakinah C SuttiratanaOffice of Health Equity Research, Yale School of Medicine, New Haven, CT, United States.
Laura M NallyDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United States.

Funding

Yale Diabetes Research CenterP30DK045735 · NIDDK · YALE UNIVERSITY · PI Kevan C Herold, GERALD I SHULMAN · 1993 to 2026
$44.0M
NIDDK NIH HHS P30 DK045735
6 · The paper itself

Abstract

Objectives: People with diabetes (PWD) face significant barriers to accessing insulin and diabetes supplies, including high prices, leading some to turn to social media for material support. This study explores emotions among PWD who have relied on assistance from social media networks when navigating access to diabetes medications and supplies (DMS). Methods: We conducted a mixed methods study of individuals with type 1 diabetes (T1D) and their caregivers who have used social media to obtain DMS. Participants were recruited through social media based on self-reported use of social media to obtain diabetes support. Transcripts of semi-structured, telephone interviews were analyzed and categorized, and consensus discussions resolved discrepancies and refined definitions of themes. Results: Thirty individuals (mean age 31+/- 8 years, 29 female, 5 caregivers) were interviewed. The analysis revealed four categories of emotions: anxiety and stress, fear of health problems and financial consequences, frustration with the healthcare system, and feelings of powerlessness and vulnerability. Nearly all interviewees reported anxiety or stress due to the financial burden of managing diabetes and fear for their or their child's health and safety. Diabetic ketoacidosis, unnecessary bodily harm or sickness, or fear of dying due to running out of insulin worried participants. Most participants described the process of obtaining DMS to be more stressful than their daily diabetes management. Conclusions: PWD described strong negative emotions related to navigating the healthcare system and acquiring DMS. Policy changes are urgently needed to support to individuals with type 1 diabetes in order to enhance their quality of life, guarantee equitable access to care, and cultivate a more compassionate and inclusive healthcare system. The reported magnitude of stress is notable, especially given the attention typically focused on the stress of diabetes management.

Indexed as

Delivery of Health CareDiabetes Mellitus, Type 1EmotionsHealth Services AccessibilityAdultAnxietyCaregiversFemaleHumansMaleMiddle AgedSocial MediaStress, PsychologicalYoung Adultbarriersdiabetes distressdiabetes suppliesemotionsfinancial stresshealthcare accesssocial mediatype 1 diabetes

Identifiers

PMID40196455
PMCPMC11973976

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.