A qualitative study exploring the expectations of people living with type 1 diabetes regarding prospective use of a hybrid closed‐loop system

Quintal, Ariane; Messier, Virginie; Rabasa‐Lhoret, Rémi; Racine, Éric

doi:10.1111/dme.14309

Cited by 11 publications

(13 citation statements)

References 23 publications

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“…In addition to the clinical benefits of the Omnipod 5 described here, the system has been designed to meet the user's desire for convenience and confident diabetes management. 42 Although participants in this study were provided with a locked-down smartphone device with the Omnipod 5 mobile app, the commercially available system will also have the option to use a downloadable mobile app on the user's personal smartphone to control Pods. The ability to control devices from personal smartphones is a much-requested feature, which enables convenience and discreet insulin delivery.…”

Section: Discussionmentioning

confidence: 99%

“…The ability to control devices from personal smartphones is a much-requested feature, which enables convenience and discreet insulin delivery. 42 …”

Section: Discussionmentioning

confidence: 99%

“…The ability to control devices from personal smartphones is a muchrequested feature, which enables convenience and discreet insulin delivery. 42 Either choice of handheld device provides automatic flow of data to the cloud-based data management system. This functionality allows caregivers to remotely monitor insulin delivery data via mobile app, similar to the Omnipod VIEWÔ app.…”

Section: Discussionmentioning

confidence: 99%

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First Outpatient Evaluation of a Tubeless Automated Insulin Delivery System with Customizable Glucose Targets in Children and Adults with Type 1 Diabetes

Forlenza

Buckingham

Brown

et al. 2021

Diabetes Technology & Therapeutics

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Background: The objective of this study was to assess the safety and effectiveness of the first commercial configuration of a tubeless automated insulin delivery system, Omnipod ® 5, in children (6–13.9 years) and adults (14–70 years) with type 1 diabetes (T1D) in an outpatient setting. Materials and Methods: This was a single-arm, multicenter, prospective clinical study. Data were collected over a 14-day standard therapy (ST) phase followed by a 14-day hybrid closed-loop (HCL) phase, where participants ( n = 36) spent 72 h at each of three prespecified glucose targets (130, 140, and 150 mg/dL, 9 days total) then 5 days with free choice of glucose targets (110–150 mg/dL) using the Omnipod 5. Remote safety monitoring alerts were enabled during the HCL phase. Primary endpoints were difference in time in range (TIR) (70–180 mg/dL) between ST and HCL phases and proportion of participants reporting serious device-related adverse events. Results: Mean TIR was significantly higher among children in the free-choice period overall (64.9% ± 12.2%, P < 0.01) and when using a 110 mg/dL target (71.2% ± 10.2%, P < 0.01), a 130 mg/dL target (61.5% ± 7.7%, P < 0.01), and a 140 mg/dL target (64.8% ± 11.6%, P < 0.01), and among adults using a 130 mg/dL target (75.1% ± 11.6%, P < 0.05), compared to the ST phase (children: 51.0% ± 13.3% and adults: 65.6% ± 15.7%). There were no serious device-related adverse events reported during the HCL phase, nor were there episodes of severe hypoglycemia or diabetic ketoacidosis. Conclusion: The Omnipod 5 System was safe and effective when used at glucose targets from 110 to 150 mg/dL for 14 days at home in children and adults with T1D.

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Section: Discussionmentioning

confidence: 99%

“…The ability to control devices from personal smartphones is a much-requested feature, which enables convenience and discreet insulin delivery. 42 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

First Outpatient Evaluation of a Tubeless Automated Insulin Delivery System with Customizable Glucose Targets in Children and Adults with Type 1 Diabetes

Forlenza

Buckingham

Brown

et al. 2021

Diabetes Technology & Therapeutics

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“…It is possible that improved glycemic control was already a standard expectation of an AP system, while a reduction in burden was suggested because it was less expected and still needed. A recent qualitative study of adults' expectations of hybrid closed‐loop systems prior to use similarly found that all participants expected the system to improve their glucose values, but fewer expected the system to improve their psychological well‐being 31 . Other research has also shown similar perspectives from participants, in which desired features were intended for benefit beyond glycemic outcomes 12 .…”

Section: Discussionmentioning

confidence: 94%

Youth and parent preferences for an ideal AP system: It is all about reducing burden

et al. 2021

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Background As new diabetes technologies improve to better manage glucose levels, users' priorities for future technologies may shift to prioritize burden reduction and ease of use. We used qualitative methods to explore youth and parent desired features of an “ideal” artificial pancreas (AP) system. Methods We conducted semi‐structured interviews with 39 youth, ages 10–25 years, and 44 parents. Interviews were audio‐recorded, transcribed, and coded using thematic analysis. Results Youth (79% female, 82% non‐Hispanic white) were (M ± SD) ages 17.0 ± 4.7 years, with diabetes for 9.4 ± 4.9 years, and HbA1c of 8.4 ± 1.1%; 79% were pump‐treated and 82% used CGM. Of parents, 91% were mothers and 86% were non‐Hispanic white. Participants suggested various ways in which an ideal AP system could reduce physical and emotional burdens of diabetes. Physical burdens could be reduced by lessening user responsibilities to manage glucose for food and exercise, and wear or carry devices. Emotional burden could be reduced by mitigating negative emotional reactions to sound and frequency of alerts, while increasing feelings of normalcy. Youth and parents differed in their suggestions to reduce emotional burden. Participants suggested features that would improve glycemia, but nearly always in the context of how the feature would directly reduce their diabetes‐specific burden. Conclusions Although participants expressed interest in improving glucose levels, the pervasive desire among suggested features of an ideal AP system was to minimize the burden of diabetes. Understanding and addressing users' priorities to reduce physical and emotional burden will be necessary to enhance uptake and maintain use of future AP systems.

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“…Moreover, treatment satisfaction was increased with the automated insulin delivery system, in line with patients' expectations regarding the prospective use of automated insulin delivery systems. 23 The two large studies of the University of Cambridge and the University of Virginia algorithms included a review of data and adjustments of therapy parameters after 2 weeks of system usage. 8,10 Moreover, it has been reported that patients transitioning to the 670G system usually adjust their insulinto-carbohydrate ratios to be more aggressive by 15%-20%.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Closed-Loop Insulin Delivery System (the Artificial Pancreas) and Sensor-Augmented Pump Therapy: A Randomized-Controlled Crossover Trial

Haidar

Legault

Raffray

et al. 2021

Diabetes Technology & Therapeutics

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Objective: Several studies have shown that closed-loop automated insulin delivery (the artificial pancreas) improves glucose control compared with sensor-augmented pump therapy. We aimed to confirm these findings using our automated insulin delivery system based on the iPancreas platform. Research Design and Methods: We conducted a two-center, randomized crossover trial comparing automated insulin delivery with sensor-augmented pump therapy in 36 adults with type 1 diabetes. Each intervention lasted 12 days in outpatient free-living conditions with no remote monitoring. The automated insulin delivery system used a model predictive control algorithm that was a less aggressive version of our earlier dosing algorithm to emphasize safety. The primary outcome was time in the range 3.9-10.0 mmol/L. Results: The automated insulin delivery system was operational 90.2% of the time. Compared with the sensoraugmented pump therapy, automated insulin delivery increased time in range (3.9-10.0 mmol/L) from 61% (interquartile range 53-74) to 69% (60-73; P = 0.006) and increased time in tight target range (3.9-7.8 mmol/L) from 37% (30-49) to 45% (35-51; P = 0.011). Automated insulin delivery also reduced time spent below 3.9 and 3.3 mmol/L from 3.5% (0.8-5.4) to 1.6% (1.1-2.7; P = 0.0021) and from 0.9% (0.2-2.1) to 0.5% (0.2-1.1; P = 0.0122), respectively. Time spent below 2.8 mmol/L was 0.2% (0.0-0.6) with sensor-augmented pump therapy and 0.1% (0.0-0.4; P = 0.155) with automated insulin delivery. Conclusions: Our study confirms findings that automated insulin delivery improves glucose control compared with sensor-augmented pump therapy. ClinicalTrials.gov no. NCT02846831.

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A qualitative study exploring the expectations of people living with type 1 diabetes regarding prospective use of a hybrid closed‐loop system

Cited by 11 publications

References 23 publications

First Outpatient Evaluation of a Tubeless Automated Insulin Delivery System with Customizable Glucose Targets in Children and Adults with Type 1 Diabetes

First Outpatient Evaluation of a Tubeless Automated Insulin Delivery System with Customizable Glucose Targets in Children and Adults with Type 1 Diabetes

Youth and parent preferences for an ideal AP system: It is all about reducing burden

Comparison Between Closed-Loop Insulin Delivery System (the Artificial Pancreas) and Sensor-Augmented Pump Therapy: A Randomized-Controlled Crossover Trial

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