Psychological outcomes of evening and night closed-loop insulin delivery under free living conditions in people with Type 1 diabetes: A 2-month randomized crossover trial
Open accessAbstract
AIM: To assess the impact on fear of hypoglycaemia and treatment satisfaction with an artificial pancreas system used for 2 consecutive months, as well as participant acceptance of the artificial pancreas system. METHODS: In a randomized crossover trial patient-related outcomes associated with an evening-and-night artificial pancreas and sensor-augmented pump therapy were compared. Both intervention periods lasted 8 weeks. The artificial pancreas acceptance questionnaire (range 0-90, higher scores better), Hypoglycaemia Fear Survey II (range 0-72, higher scores worse) and Diabetes Treatment Satisfaction Questionnaire (range 0-36, higher scores better) were completed by 32 participants. Semi-structured interviews were conducted after study completion in a subset of six participants. Outcomes were compared using a repeated-measures anova model or paired t-test when appropriate. RESULTS: The total artificial pancreas acceptance questionnaire score at the end of the artificial pancreas period was 69.1 (sd 14.7; 95% CI 63.5, 74.7), indicating a positive attitude towards the artificial pancreas. No significant differences were found among the scores at baseline, end of sensor-augmented pump therapy period or end of the artificial pancreas period with regard to fear of hypoglycaemia [28.2 (sd 17.5), 23.5 (sd 16.6) and 23.5 (sd 16.7), respectively; P = 0.099] or diabetes treatment satisfaction [29.0 (sd 3.9), 28.2 (sd 5.2) and 28.0 (sd 7.1), respectively; P = 0.43]. Themes frequently mentioned in the interviews were 'positive effects at work', 'improved blood glucose', 'fewer worries about blood glucose', but also 'frequent alarms', 'technological issues' and 'demand for an all-in-one device'. CONCLUSIONS: The psychological outcomes of artificial pancreas and sensor-augmented pump therapy were similar. Current artificial pancreas technology is promising but user concerns should be taken into account to ensure utility of these systems.
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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 [29]
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Home Use of an Artificial Beta Cell in Type 1 Diabetes
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Advanced Diabetes Management Using Artificial Intelligence and Continuous Glucose Monitoring Sensors
Vettoretti, M., Cappon, G., Facchinetti, A., & Sparacino, G. (2020) · Sensors · doi:10.3390/s20143870 · Cited by 176 · see citing works
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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., et al. (2017) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0007 · Cited by 37 · see citing works
- Authors
- Kropff, J., DeJong, J., del Favero, S., Place, J., Messori, M., Coestier, B., Farret, A., Boscari, F., Galasso, S., Avogaro, A., Bruttomesso, D., Cobelli, C., Renard, E., Magni, L., DeVries, J. H., & the AP@home consortium
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Information Engineering University of Padova Padova Italy
- Centre Hospitalier Universitaire de Montpellier (FR)
- University of Pavia (IT)
- University of Padua (IT)
- Endocrinology, Diabetes, Nutrition Montpellier University Hospital Montpellier France
- Corresponding author
- Kropff, J.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2016-10-28
- Volume
- 34
- Issue
- 2
- Pages
- 262-271
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC5248649
- OpenAlex
- W2528877804
- Cited by
- 40
- References
- 12
- Citations by year
- 2025: 1 · 2024: 6 · 2023: 3 · 2022: 1 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 1
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetic Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- HAL (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc)
- Funders
- Seventh Framework Programme (247138)
- 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, sensor-augmented pump therapy, fear of hypoglycemia, diabetes treatment satisfaction, device acceptance, psychological outcomes, free-living conditions
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Fear, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Surveys and Questionnaires, Patient Satisfaction, Cross-Over Studies, Pancreas, Artificial
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