The impact of using a closed-loop system on food choices and eating practices among people with Type 1 diabetes: a qualitative study involving adults, teenagers and parents.
Diabetic medicine : a journal of the British Diabetic Association
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Lawton, J., Blackburn, M., Rankin, D., Allen, J., Campbell, F., Leelarathna, L., Tauschmann, M., et al. (2019). The impact of using a closed-loop system on food choices and eating practices among people with Type 1 diabetes: a qualitative study involving adults, teenagers and parents.. Diabetic medicine : a journal of the British Diabetic Association, 36 (6), 753-760. https://doi.org/10.1111/dme.13887
Aim: While closed-loop systems are being developed to lessen the burden of diabetes self-management and improve glycaemic control, there may be unintended consequences to using this technology We explored whether, how, and why, moving onto and using a hybrid day-and-night closed-loop system affected people’s food choices and dietary practices to better understand the impact of this technology on everyday life and help inform recommendations for training and support given to future users. Methods: 24 adults, adolescents and parents were interviewed before commencing use of the closed-loop system and following its three-month use. Data were analysed thematically and longitudinally. Results: While participants described preparing and/or eating similar meals to those consumed prior to using a closed-loop, many described feeling more normal and less burdened by diabetes in dietary situations. Individuals also noted how use of this technology could lead to deskilling (less precise carbohydrate counting) and less healthy eating (increased snacking, portion sizes and consumption of fatty, energy dense foods), due to the perceived ability of the system to deal with errors in carbohydrate counting and address small rises in blood glucose without a corrective dose needing to be administered. Conclusions: While there may be quality of life benefits to using a closed-loop individuals might benefit from additional nutritional and behavioural education to help promote healthy eating. Refresher training in carbohydrate counting may also be necessary to help ensure users are able to undertake diabetes management in situations where the technology might fail or they take a break from using it.
APCam11 Consortium, Humans, Diabetes Mellitus, Type 1, Insulin, Blood Glucose, Blood Glucose Self-Monitoring, Insulin Infusion Systems, Diet, Longitudinal Studies, Feeding Behavior, Food Preferences, Parents, Choice Behavior, Qualitative Research, Quality of Life, Adolescent, Adult, Middle Aged, Female, Male, Young Adult, Surveys and Questionnaires
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Juvenile Diabetes Research Foundation Ltd (JDRF) (2-SRA-2014-256-M-R)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (UC4DK108520)
External DOI: https://doi.org/10.1111/dme.13887
This record's URL: https://www.repository.cam.ac.uk/handle/1810/287610