RT Journal Article
SR Electronic
T1 Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e000025
DO 10.1136/bmjdrc-2014-000025
VO 2
IS 1
A1 Katharine D Barnard
A1 Tim Wysocki
A1 Janet M Allen
A1 Daniela Elleri
A1 Hood Thabit
A1 Lalantha Leelarathna
A1 Arti Gulati
A1 Marianna Nodale
A1 David B Dunger
A1 Tannaze Tinati
A1 Roman Hovorka
YR 2014
UL http://drc.bmj.com/content/2/1/e000025.abstract
AB Objective To explore the experiences of adolescents with type 1 diabetes mellitus (T1DM) and their parents taking part in an overnight closed loop study at home, using qualitative and quantitative research methods. Research design and methods Adolescents aged 12–18 years on insulin pump therapy were recruited to a pilot closed loop study in the home setting. Following training on the use of a study insulin pump and continuous glucose monitoring (CGM), participants were randomized to receive either real-time CGM combined with overnight closed loop or real-time CGM alone followed by the alternative treatment for an additional 21 days with a 2–3-week washout period in between study arms. Semistructured interviews were performed to explore participants’ perceptions of the impact of the closed loop technology. At study entry and again at the end of each 21-day crossover arm of the trial, participants completed the Diabetes Technology Questionnaire (DTQ) and Hypoglycemia Fear Survey (HFS; also completed by parents). Results 15 adolescents and 13 parents were interviewed. Key positive themes included reassurance/peace of mind, confidence, ‘time off’ from diabetes demands, safety, and improved diabetes control. Key negative themes included difficulties with calibration, alarms, and size of the devices. DTQ results reflected these findings. HFS scores were mixed. Conclusions Closed loop insulin delivery represents cutting-edge technology in the treatment of T1DM. Results indicate that the psychological and physical benefits of the closed loop system outweighed the practical challenges reported. Further research from longitudinal studies is required to determine the long-term psychosocial benefit of the closed loop technology.