title: Patient perspectives on personalized glucose advisory systems for type 1 diabetes management.
abstract: BACKGROUND
  Diabetes technology is rapidly advancing toward fully automated glucose control systems, but little is known about patient perspectives on these systems. This study aimed to gather qualitative and quantitative data on patient attitudes and concerns about using a personalized glucose advisory system (PGASystem) for diabetes management.
  
  
  METHODS
  Fifty-six adults with type 1 diabetes on insulin pump therapy participated in focus group interviews following use of an insulin pump and continuous glucose monitoring for 4 weeks in a parent study to develop a PGASystem. Focus groups were transcribed and coded for thematic content.
  
  
  RESULTS
  All participants endorsed the desire to use a PGASystem, and the majority wanted advice from the system on all aspects of insulin delivery. However, participants indicated that they might be reluctant to follow such advice because of the following concerns: how the advice was generated, relinquishing control to automated technology, and inadequate personalization of the system. Participants believed the system would need to consider numerous factors related to their food, activities, and other personal information to provide optimally individualized advice. The majority also reported difficulties with behavioral event recording on their insulin pumps, and approximately one-third endorsed difficulty with accurate carbohydrate counting.
  
  
  CONCLUSIONS
  Adults with type 1 diabetes appear to be enthusiastic about using a PGASystem system for their diabetes management but also have significant concerns affecting their overall willingness to follow such a system's advice. Addressing these concerns will be crucial in the future development of glucose advisory and control technology.
authors.affiliation: Behavioral Medicine Center, University of Virginia, Charlottesville, Virginia 22908, USA.
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Shepard
authors.forename: Linda
authors.initials: L
authors.lastname: Gonder-Frederick
authors.forename: Karen
authors.initials: K
authors.lastname: Vajda
authors.forename: Boris
authors.initials: B
authors.lastname: Kovatchev
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004032:Diet; D005260:Female; D017144:Focus Groups; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D019397:Pancreas, Artificial / Q000639:trends; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000639:trends; D017060:Patient Satisfaction; D057285:Precision Medicine / Q000706:statistics & numerical data / Q000639:trends; D036301:Qualitative Research
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin