Trust in hybrid closed loop among people with diabetes: Perspectives of experienced system users

Abstract

Automated closed loop systems will greatly change type 1 diabetes management; user trust will be essential for acceptance of this new technology. This qualitative study explored trust in 32 individuals following a hybrid closed loop trial. Participants described how context-, system-, and person-level factors influenced their trust in the system. Participants attempted to override the system when they lacked trust, while trusting the system decreased self-management burdens and decreased stress. Findings highlight considerations for fostering trust in closed loop systems. Systems may be able to engage users by offering varying levels of controls to match trust preferences.

Participants' Experiences of, and Views About, Daytime Use of a Day-and-Night Hybrid Closed-Loop System in Real Life Settings: Longitudinal Qualitative Study

“…Given these collaborative opportunities applied to daytime use, and were only identified over time, it is unsurprising that they have not been reported in studies involving users of nighttime systems 7-12 and 24-h systems used for short durations. 2,13,14 In line with participants' suggestions, systems could be developed which allow users to communicate information about plans and intentions on atypical days and which discriminate between weekdays and weekends. To help prevent hyperglycemic excursions when doing resistance/highintensity training, and hypoglycemic excursions when doing aerobic/endurance training, systems which allow users to input information about the intensity and type of planned activity could also be considered.…”

Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial

“…System errors requiring a reset meant that the algorithm returned to participant-naive parameters. Technical issues may have reduced participants' trust, which may also have contributed to them being tempted to override the algorithm's advice (26).…”

What Training, Support, and Resourcing Do Health Professionals Need to Support People Using a Closed-Loop System? A Qualitative Interview Study with Health Professionals Involved in the Closed Loop from Onset in Type 1 Diabetes (CLOuD) Trial

“…To date, most studies have focused on the experiences of people with type 1 diabetes and/or their family members when using closed-loop systems. [3][4][5][6][7][8][9][10][11][12][13] Health professionals' perspectives have only received limited attention, including their views about the training, support, and resourcing needed to support individuals using the technology in routine clinical care. This is an important omission, given the evidence that a key mediating factor in people's access to and experience of using diabetes technologies is professionals being appropriately trained and supported.…”