Parental attitudes towards overnight closed-loop glucose control in children with type 1 diabetes.
BACKGROUND
This study examined parental attitudes towards overnight closed-loop (CL) glucose control in children and young people with type 1 diabetes (T1D).


METHODS
Twelve families recruited by the INsulin PUmp Therapy group (INPUT), a U.K. patient/carer-led support group for people with T1D, attended a focus meeting on CL. The concept of CL was explained, and clinical results and plans regarding the Artificial Pancreas Project at Cambridge were presented. Participants completed a questionnaire to evaluate parental feelings about T1D management and attitudes towards overnight CL insulin delivery.


RESULTS
Nineteen parents (12 mothers and seven fathers) anonymously completed the questionnaire. Main concerns about diabetes were related to long-term complications (84%) and hypoglycemia (16%). Achieving good glucose control represented major challenge for carers (83%) with nighttime being the most difficult period to manage (56%), worrying most parents (71%) particularly because of fear of hypoglycemia (33%). The development of CL to manage diabetes was welcomed by all parents (100%) with 95% happy for their child to wear a continuous glucose monitor together with an insulin pump. All parents were ready to respond to additional alarms at night with 90% parents not worried about their child's overnight insulin delivery being controlled by a computer.


CONCLUSIONS
Selected parents of children with T1D who are already insulin pump users express implied trust in the technology for overnight CL insulin delivery. Nighttime blood glucose control is the biggest challenge and concern for parents, and the development of a commercially available overnight CL system may be an important goal.
Elleri
Daniela
D
Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, United Kingdom.
Acerini
Carlo L
CL
Allen
Janet M
JM
Hayes
Josephine
J
Pesterfield
Claire
C
Wilinska
Malgorzata E
ME
Dunger
David B
DB
Hovorka
Roman
R
D000293:Adolescent; D000328:Adult; D001007:Anxiety; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy* / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D006706:Homeostasis; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000523:psychology*; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin