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“It is definitely a game changer”: A qualitative study of experiences with in-home overnight closed-loop technology among adults with type 1 diabetes

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Hendrieckx, Christel, Poole, Lucinda A., Sharifi, Amin, Jayawardene, Dilshani, Loh, Margaret M., Horsburgh, Jodie C., Bach, Leon A., Colman, Peter G. +8 more·2017·Diabetes Technology & Therapeutics
DOI 10.1089/dia.2017.0007
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Abstract

BACKGROUND: This qualitative study explored trial participants' experiences of four nights of in-home closed loop. METHODS: Sixteen adults with type 1 diabetes, who completed a randomized crossover trial, were interviewed after four consecutive nights of closed-loop. Interviews were audio recorded, transcribed, and analyzed with a coding framework developed to identify the main themes. RESULTS: Participants had a mean age of 42 ± 10 years, nine were women; mean diabetes duration was 27 ± 7 years, and all were using insulin pumps. Overall, first impressions were positive. Participants found closed-loop easy to use and understand. Most experienced more stable overnight glucose levels, although for some these were similar to usual care or higher than they expected. Compared with their usual treatment, they noticed the proactive nature of the closed-loop, being able to predict trends and deliver micro amounts of insulin. Most reported technical glitches or inconveniences during one or more nights, such as transmission problems, problematic connectivity between devices, ongoing alarms despite addressing low glucose levels, and sensor inaccuracy. Remote monitoring by the trial team and their own hypoglycemic awareness contributed to feelings of trust and safety. Although rare, safety concerns were raised, related to feeling unsure whether the system would respond in time to falling glucose levels. CONCLUSIONS: This study provides relevant insights for implementation of closed-loop in the real world. For people with diabetes who are less familiar with technology, remote monitoring for the first few days may provide reassurance, strengthen their trust/skills, and make closed-loop an acceptable option for more people with type 1 diabetes.

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  • DSSs for patients offer an alternative to closed-loop systems because many users do not feel confident using the artificial pancreas.

    “These DSSs for patients offer an alternative to closed-loop systems. Indeed, many users do not feel confident about using the artificial pancreas [28,29], as they are concerned about possible errors occurring in the insulin pump and so prefer an open-loop therapy (i.e., a therapy in which the patient manually sets the insulin doses), which can be assisted by a DSS.”

    From Advanced Diabetes Management Using Artificial Intelligence and Continuous Glucose Monitoring Sensors (2020) · cites this paper as [28]

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Authors
Hendrieckx, C., Poole, L. A., Sharifi, A., Jayawardene, D., Loh, M. M., Horsburgh, J. C., Bach, L. A., Colman, P. G., Kumareswaran, K., Jenkins, A. J., MacIsaac, R. J., Ward, G. M., Grosman, B., Roy, A., O'Neal, D. N., & Speight, J.
Affiliations
  • Deakin University (AU)
  • St Vincent's Hospital Melbourne (AU)
  • The Alfred Hospital (AU)
  • The Royal Melbourne Hospital (AU)
  • The University of Sydney (AU)
  • The University of Melbourne (AU)
  • Medtronic (United States) (US)
Corresponding author
Hendrieckx, Christel
ORCID
Venue
Diabetes Technology & Therapeutics
Publisher
SAGE Publications
Published
2017-07
Volume
19
Issue
7
Pages
410-416
ISSN
  • 1520-9156 (ISSN-L)
  • 1557-8593
DOI
10.1089/dia.2017.0007
OpenAlex
W2617858914
Cited by
37
References
15
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 4 · 2019: 7 · 2018: 2
FWCI
2.81
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Technology & Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Juvenile Diabetes Research Foundation United States of America
  • Deakin University
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 1 diabetes, artificial pancreas, continuous glucose monitoring, insulin pump, patient experience, remote monitoring, hypoglycemia, technology acceptance
MeSH terms
Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Humans, Insulin Infusion Systems, Male, Middle Aged, Blood Glucose Self-Monitoring, Cross-Over Studies, Qualitative Research

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