Psychosocial Aspects of Closed and Open Loop Insulin Delivery: Closing the Loop In Adults with Type 1 Diabetes in the Home Setting
Barnard, Katharine D
Wiley on behalf of Diabetes UK
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Barnard, K. D., Wysocki, T., Thabit, H., Evans, M., Amiel, S., Heller, S., Young, A., & et al. (2015). Psychosocial Aspects of Closed and Open Loop Insulin Delivery: Closing the Loop In Adults with Type 1 Diabetes in the Home Setting. Diabetic Medicine, 32 601-608. https://doi.org/10.1111/dme.12706
Aim: to explore 1) psychosocial experiences of closed loop technology and 2) compare ratings of closed and open loop technology for adults with type 1 diabetes taking part in a randomized crossover study. Methods: Adults age >18 years on insulin pump therapy were recruited to received real-time continuous glucose monitoring (CGM) with overnight closed-loop or real-time CGM alone (open loop) followed by the alternative treatment randomly, at home for 4-weeks unsupervised. Participants were invited to share their views in semi-structured interviews. Impact of the closed loop technology, positive and negative aspects of living with the device overnight, alongside hopes and anxieties were explored. Results: Participants: 24 adults, mean age 43(SD 12), 54% male. Interview duration 12-46 minutes (mean 26 minutes). Content and thematic analysis revealed key positive themes: Improved blood glucose control (n=16); Reassurance/reduced worry (n=16); Improved overnight control leading to improved daily functioning and diabetes control (n=16); Improved sleep (n=8). Key negative themes: Technical difficulties (n=24); Intrusiveness of alarms (n=13); Size of equipment (n=7). Twenty participants would recommend the closed loop technology. Conclusions: Closed loop has positive effects when it works in freeing participants from the demands of self-management. The downside for those who had more negative views was generally down to technical difficulties particularly around the pump and ‘connectivity’ which should hopefully improve. Future research should continue to explore acceptability as a realistic therapy option, taking account of user concerns as new systems are designed. Failure to do this may reduce the eventual utility of new systems.
External DOI: https://doi.org/10.1111/dme.12706
This record's URL: https://www.repository.cam.ac.uk/handle/1810/249226