Experiences of closed‐loop insulin delivery among pregnant women with Type 1 diabetes

Abstract

Women displayed complex psychosocial responses to closed-loop therapy in pregnancy. Perceptions of glycaemic response may diverge from biomedical data.

Psychosocial impacts of hybrid closed‐loop systems in the management of diabetes: a review

“…Those using systems for longer periods seemed to experience more benefits than those using systems for shorter periods , whereas those with more positive attitudes to technology seemed to overestimate their benefit from closed‐loop usage more than those with more cautious attitudes . Reported burdens included technical difficulties, alarm intrusiveness and interrupted sleep, increased time spent thinking about diabetes, size and appearance of the equipment, limitations on exercise, and perceptions of deskilling and data obsession . Apart from the markedly positive response of children using dual‐hormone systems at youth camps , reported benefits and burdens were broadly similar across different user‐groups, although considerably more research has been conducted with adult participants than with paediatric and pregnant participants.…”

“…Farrington et al . adopted a mixed‐methods approach to examine psychosocial experiences of closed‐loop systems used by pregnant women in a randomized, open‐label, crossover study comparing 4 weeks of closed‐loop with 4 weeks of open‐loop (sensor‐augmented pump) therapy. Thirteen women were interviewed twice each, at baseline during device training and following completion of the study; an additional participant was interviewed at follow‐up only.…”

Adaptability of Closed-Loop during Labor, Delivery, and Postpartum—A Secondary Analysis of Data From Two Randomized Crossover Trials in Type 1 Diabetes Pregnancy

“…We also lack data regarding the acceptability of the system to hospital staff, although participants themselves expressed generally high levels of satisfaction regarding closed-loop experiences in semistructured interviews conducted in related psychosocial studies. 8 Thematic analysis of these interviews revealed no negative comments regarding participants' experiences of closed loop. Participants' positive comments included: ''it just took all the worry away, to be honest'' (Participant 15, day-and-night trial); ''there was me saying to all these doctors, no I'd rather stay on that [closed-loop], not the sliding scale.''…”

“…7 Furthermore, some women report feeling vulnerable when the ability to control their own glucose is taken away from them and is instead ''in the hands'' of less experienced obstetric ward staff. 8 For women who continue managing their own insulin delivery, the burden of frequent monitoring and insulin dose adjustments can be stressful. 9 A hybrid closed-loop system uses a continuous glucose monitor (CGM), CSII, and computer algorithm to provide automated glucose-responsive insulin delivery.…”

The impact of using a closed‐loop system on food choices and eating practices among people with Type 1 diabetes: a qualitative study involving adults, teenagers and parents

“…These systems need varying levels of user input, with most requiring users to count carbohydrates and announce this information prior to snacking or eating a meal [1]. While studies have previously consulted users of closed-loop systems, these have often focused on experiences of overnight systems [4][5][6][7][8][9] and/or systems used for very short periods (typically ≤5 days) in supervised environments [10][11][12], with none focusing specifically on how the use of a closed-loop might affect users' dietary practices. Specifically, it has been hypothesized that the use of a closed-loop may result in a transition from what has been termed 'restrained' to 'nonrestrained' eating behaviour, prompting calls for further research [3].…”