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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.

Accepted version
Peer-reviewed

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Type

Article

Change log

Authors

Blackburn, M 
Allen, J 
Campbell, F 

Abstract

AIMS: 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 inform recommendations for training and support given to future users. METHODS: Twenty-four adults, adolescents and parents were interviewed before commencing use of the closed-loop system and following its 3-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 the use of this technology could lead to deskilling (less precise carbohydrate counting) and less healthy eating (increased snacking and portion sizes and consumption of fatty, energy-dense foods) because of 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 that users are able to undertake diabetes management in situations where the technology might fail or that they take a break from using it.

Description

Keywords

Adolescent, Adult, Blood Glucose, Blood Glucose Self-Monitoring, Choice Behavior, Diabetes Mellitus, Type 1, Diet, Feeding Behavior, Female, Food Preferences, Humans, Insulin, Insulin Infusion Systems, Longitudinal Studies, Male, Middle Aged, Parents, Qualitative Research, Quality of Life, Surveys and Questionnaires, Young Adult

Journal Title

Diabet Med

Conference Name

Journal ISSN

0742-3071
1464-5491

Volume Title

36

Publisher

Wiley
Sponsorship
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 (UC4DK108520)
NIHR Evaluation Trials and Studies Coordinating Centre (14/23/09)