Table 2 Primary authors’ recommendations to improve parent/caregiver support in relation to each analytical theme

1. Monopolisation of life

To help reduce the detrimental impact on parents’ psychological and emotional wellbeing, the primary authors recommended that healthcare professionals could: ascertain and address issues related to hypoglycaemia concerns, lapses in confidence and sleep [23]; and, provide encouragement and support by acknowledging the unpredictability of diabetes and treatment outcomes [22]. More general recommendations included professionals needing to familiarise themselves with the symptoms of burnout [32], and helping parents address any harmful emotions related to their caregiving situation [33]. This could involve: teaching parents strategies to manage negative feelings about the child being ‘different’ because of diabetes [26]; and, assessing and encouraging parental self-care, including helping to identify sources of respite [23]. Finally, to help reduce anxieties related to social stigma and gendered impacts, primary authors recommended that healthcare professionals seek to improve public awareness and understanding of type 1 diabetes [27, 34, 35].

To help relieve the care burden on mothers and encourage fathers’ involvement, primary authors recommended that professionals should, from the outset, set the expectation that (where possible) both parents attend clinic consultations [28] and that, for respite and emergency purposes, both should be involved in their child’s diabetes management [25]. This recommendation could be supported by working with parents to develop a ‘division of labour’ plan [23].

To alleviate parents’ concerns regarding potentially inappropriate diabetes management in daycare settings (e.g. nurseries, schools, playgroups), primary authors recommended that healthcare professionals should help educate staff on safe management practices [23] and, where possible, broaden their outreach work in these settings to increase the number of people available to support the child’s diabetes management [28].

To address potential financial pressures related to the child’s diabetes treatment, primary authors recommended that healthcare professionals should provide parents with financial guidance about all aspects of diabetes management [27] and offer referral to charitable organisations where appropriate [34].

2. Parents’ experiences of professional and informal support

To address parents’ concerns regarding their diabetes management education and avoid mixed messages, primary authors recommended that healthcare professionals should develop and follow an agreed-upon teaching plan; this should include the option of booster sessions, which revisit information and techniques taught at the time of diagnosis [25] and take into consideration individuals’ differing speeds of learning and developing confidence [24].

To alleviate potential tensions between parents’ and professionals’ views regarding diabetes management, primary authors recommended that healthcare professionals should educate parents on their specific clinical perspective [28], while also using parents’ knowledge regarding their unique family situation and the child’s individual needs to inform treatment decisions [28, 31].