Lived Experience of Advanced Hybrid Closed-Loop Versus Hybrid Closed-Loop: Patient-Reported Outcomes and Perspectives

Hood, Korey K.; Laffel, Lori M.; Danne, Thomas; Nimri, Revital; Weinzimer, Stuart A.; Sibayan, Judy; Bailey, Ryan; Schatz, Desmond; Bratina, Nataša; Bello, Rachel; Punel, Alina; Calhoun, Peter; Beck, Roy W.; Bergenstal, Richard M.; Phillip, Moshe

doi:10.1089/dia.2021.0153

Cited by 39 publications

(30 citation statements)

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“…A recent study found that diabetes technologies prompted children and their parents to use data in daily care and that technologies could be liberating but also result in excess control (17). Diabetes can be stressful and demanding, but if the outcome (good glycemic control) exceeds expectations, even a demanding device can be accepted (18)(19)(20). We found that good TIR results were associated with improvements in emotional well-being.…”

Section: Discussionmentioning

confidence: 66%

Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

et al. 2022

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Objective To evaluate the six-month impact of the advanced automated functions of a closed-loop control (CLC) system (Control-IQ) and a virtual educational camp (vEC) on emotions and time in range (TIR) of children and adolescents with type 1 diabetes. Methods Children and their parents participated in a three-day vEC. Clinical, glucose, and emotion data were evaluated before, just after, and six months after the vEC. Emotions were evaluated using adapted Plutchik's and Geneva Emotion Wheels. Results Forty-three children and adolescents (7-16 years) showed significant improvements in positive emotions immediately and six months after the vEC (67% and 65% vs 38%, p < 0.05, respectively), while mixed emotions were reduced (32% and 15% vs 61%, p < 0.05 and p < 0.001, respectively). The median percentage TIR increased from 64% (IQR 54-72) to 75% (IQR 70-82) with Control-IQ (p < 0.001) six months after the vEC. Conclusions Positive emotions (joy, serenity, and satisfaction) significantly improved while mixed emotions were significantly worse six months after the initiation of a CLC system (Control-IQ) and a vEC.

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Section: Discussionmentioning

confidence: 66%

Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

et al. 2022

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“…Children and adolescents reported lower levels of fear, emotional distress, and increased well-being related to their T1DM. A recent clinical trial evaluating AHCL reports improved results from emotional burden scale, and behavioral burden, but no changes in distress or hypoglycemia confidence; it is of interest that satisfaction was greater in those who were more frequently in auto-mode (22). A group from Australia also showed improved glycemic control and improved diabetes treatment satisfaction as a possible consequence of reduced worry and increased trust in AHCL (23).…”

Section: Discussionmentioning

confidence: 99%

Patient reported outcome measures in children and adolescents with type 1 diabetes using advanced hybrid closed loop insulin delivery

et al. 2022

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PurposeTo determine the impact of advanced hybrid closed - loop (AHCL) insulin delivery on quality of life, metabolic control and time in range (TIR) in youth with type 1 diabetes mellitus (T1DM).MethodsTwenty-four children and adolescents with T1DM (14 female) aged of 10 to 18 years participated in the study. Mixed methods study design was implemented. Quantitative part of the study was conducted as a longitudinal crossover study with data collection before and at the end of AHCL use. Qualitative data were obtained with modeled interviews of four focus groups before and the end of the period. Clinical data were collected from the electronic medical records.ResultsThe use of AHCL significantly improved the quality of life in terms of decreased fear of hypoglycemia (p<0.001), decrease in diabetes-related emotional distress (p<0.001), and increased wellbeing (p=0.003). The mean A1C decreased from 8.55 ± 1.34% (69.9 ± 12.3 mmol/mol) to 7.73 ± 0.42 (61.1 ± 2.2 mmol/mol) (p=0.002) at the end of the study. Mean TIR was 68.22% (± 13.89) before and 78.26 (± 6.29) % (p<0.001) at the end of the study.ConclusionThe use of advanced hybrid closed loop significantly improved the quality of life and metabolic control in children and adolescents with T1DM.

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“…Dabei ist nicht entscheidend, wie viel Technologie genutzt wird, sondern, dass diese spürbar positive Folgen hat und den täglichen Aufwand für die Erkrankung senkt. Für neue Entwicklungen bei der zunehmend automatisierten Insulingabe durch Hybrid-closed-Loop-Systeme konnten hier besonders unter jungen Erwachsenen eindrucksvolle Erfolge bezogen auf die Zeit im Zielbereich (TiR), die Rate akuter Komplikationen, die Schlafqualität, das Wohlbefinden und die Zufriedenheit der Nutzer belegt werden [ 29 , 30 ].…”

Section: Therapieprinzipien Bei Jungen Erwachsenenunclassified

Aus Sicht der Diabetespraxis: erwachsen werden mit Typ-1-Diabetes

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2022

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Junge Erwachsene mit Typ-1-Diabetes tragen die Verantwortung für ihre Diabetestherapie weitgehend selbst, gleichzeitig genießen sie neu gewonnene Freiheiten und sind eher risikobereit. Die eigene Wohnung, Partnerschaft, Studium, Beruf und weitere Entwicklungsaufgaben stellen hohe Anforderungen. Diese sind oft schwer mit einer qualifizierten Diabetestherapie vereinbar. Nach der langjährigen persönlichen Bindung an das Team einer Kinderklinik ist der Wechsel in eine internistische Diabetesschwerpunktpraxis nicht immer reibungslos. Individuelle psychische Belastungen und ein unzureichendes Diabetesmanagement verstärken sich dabei gegenseitig. Diabetes verkörpert in diesem Lebensabschnitt genau das Gegenteil von all dem, was altersgemäß ist. Er erfordert einen strukturierten Tagesablauf, disziplinierte Ernährung, regelmäßige Arztbesuche und vorausschauendes Denken und Handeln. Die Analyse der CGM-Daten (CGM: kontinuierliche Glukosemessung [„continuous glucose monitoring“]) in der Diabetespraxis erlaubt detaillierte Einblicke in den persönlichen Alltag, die mit Scham- und Schuldgefühlen verbunden sein können. Ziel der Langzeitbehandlung ist es, alle diese Aspekte – aktuelle Lebensqualität, persönliche Ziele, Vermeidung akuter Diabeteskomplikationen und Prävention langfristiger kardiovaskulärer Folgekomplikationen – zu beachten und daraus partizipativ ein individuelles Behandlungskonzept zu entwickeln. Die wichtigste Aufgabe der Diabetespraxis ist dabei, junge Menschen auf ihrem individuellen Weg zu unterstützen, ihre Stärken anzuerkennen und sie durch Erfolge zu motivieren.

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Lived Experience of Advanced Hybrid Closed-Loop Versus Hybrid Closed-Loop: Patient-Reported Outcomes and Perspectives

Cited by 39 publications

References 16 publications

Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

Patient reported outcome measures in children and adolescents with type 1 diabetes using advanced hybrid closed loop insulin delivery

Aus Sicht der Diabetespraxis: erwachsen werden mit Typ-1-Diabetes

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