title: Accessibility of insulin pumps for blind and visually impaired people.
abstract: BACKGROUND
  Continuous subcutaneous insulin infusion using an insulin pump (IP) more closely mimics the normal pancreas than multiple insulin injections. It is an effective, and often a preferred, means of maintaining normal blood glucose levels, but IPs were not designed to be fully accessible to blind or visually impaired people. This study will identify accessibility issues related to the design of IPs and focus on the key improvements required in the user interface to provide access for people who are blind or visually impaired.
  
  
  METHODS
  IPs that are commercially available were evaluated, and features and functions such as operating procedures, user interface design, and user manuals were tabulated and analyzed. Potential failures and design priorities were identified through a Failure Modes and Effects Analysis (FMEA).
  
  
  RESULTS
  Although the IPs do provide some limited audio output, in general, it was found to be of minimal use to people who are blind or visually impaired. None of the IPs uses high-contrast displays with consistently large fonts preferred by people who are visually impaired. User manuals were also found to be of minimal use. Results of the FMEA emphasize the need to focus design improvements on communicating and verifying information so that errors and failures can be detected and corrected.
  
  
  CONCLUSIONS
  The most important recommendation for future IP development is speech output capability, which, more than any other improvement, would break down accessibility barriers and allow blind and visually impaired people to take advantage of the benefits of IP technology.
authors.affiliation: American Foundation for the Blind, Technology and Employment Center at Huntington, Huntington, West Virginia 25701, USA. muslan@afb.net
authors.forename: Mark M
authors.initials: MM
authors.lastname: Uslan
authors.forename: Darren M
authors.initials: DM
authors.lastname: Burton
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Chertow
authors.forename: Ronda
authors.initials: R
authors.lastname: Collins
mesh_terms: D001296:Audiovisual Aids; D001766:Blindness / Q000534:rehabilitation*; D001786:Blood Glucose / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000534:rehabilitation*; D004282:Documentation; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D007332:Insulin Infusion Systems; D008370:Manuals as Topic; D012449:Safety; D013060:Speech; D014786:Vision Disorders / Q000534:rehabilitation*
chemical_list: D001786:Blood Glucose