Expectations and Attitudes of Individuals With Type 1 Diabetes After Using a Hybrid Closed Loop System.
Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. The purpose of this study was to explore the benefits, expectations, and attitudes of individuals with T1D following a clinical trial of an HCL system. Methods Thirty-two individuals with T1D (17 adults, 15 adolescents) participated in focus groups after 4 to 5 days of system use. Content analysis generated themes regarding perceived benefits, hassles, and limitations. Results Some participants felt misled by terms such as "closed loop" and "artificial pancreas," which seemed to imply a more "hands-off" experience. Perceived benefits were improved glycemic control, anticipated reduction of long-term complications, better quality of life, and reduced mental burden of diabetes. Hassles and limitations included unexpected tasks for the user, difficulties wearing the system, concerns about controlling highs, and being reminded of diabetes. Conclusion Users are willing to accept some hassles and limitations if they also perceive health and quality-of-life benefits beyond current self-management. It is important for clinicians to provide a balanced view of positives and negatives to help manage expectations.
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).
Esti
E
Iturralde
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).
Molly L
ML
Tanenbaum
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).
Sarah J
SJ
Hanes
Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, California (Ms Suttiratana).
Sakinah C
SC
Suttiratana
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut (Dr Ambrosino, Dr Weinzimer).
Jodie M
JM
Ambrosino
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).|Insulet Corporation, Billerica, Massachusetts (Dr Ly).
Trang T
TT
Ly
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).|Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, Colorado (Dr Maahs, Dr Walders-Abramson).
David M
DM
Maahs
Department of Psychiatry, Stanford University School of Medicine, Stanford, California (Dr Naranjo, Dr Hood).
Diana
D
Naranjo
Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, Colorado (Dr Maahs, Dr Walders-Abramson).
Natalie
N
Walders-Abramson
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut (Dr Ambrosino, Dr Weinzimer).
Stuart A
SA
Weinzimer
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).
Bruce A
BA
Buckingham
Department of Pediatrics, Stanford University School of Medicine, Stanford, California (Dr Iturralde, Dr Tanenbaum, Ms Hanes, Dr Ly, Dr Maahs, Dr Buckingham, Dr Hood).|Department of Psychiatry, Stanford University School of Medicine, Stanford, California (Dr Naranjo, Dr Hood).
Korey K
KK
Hood
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008297:Male; D019397:Pancreas, Artificial; D016896:Treatment Outcome; D055815:Young Adult
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin