Closing the Loop in Adults, Children and Adolescents With Suboptimally Controlled Type 1 Diabetes Under Free Living Conditions: A Psychosocial Substudy.
Closing the Loop in Adults, Children and Adolescents With Suboptimally Controlled Type 1 Diabetes Under Free Living Conditions: A Psychosocial Substudy.
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DOI：
10.1177/1932296817702656
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发表时间：
2017-11-01
影响因子：
5
通讯作者：
Hovorka, Roman
中科院分区：
文献类型：
--
作者：
Barnard, Katharine D;Wysocki, Timothy;Hovorka, Roman
目的：通过两项多中心、自由生活、随机交叉家庭研究，探讨1型糖尿病成人、儿童和青少年及其父母使用闭环技术的心理社会体验。方法：使用胰岛素泵治疗的参与者被随机分配到12周的自动闭环血糖控制，然后12周的传感器增强胰岛素泵治疗（开环），反之亦然。成人24小时使用闭环，儿童和青少年只使用夜间闭环。参与者定期完成糖尿病技术问卷（DTQ），并在半结构化访谈中分享他们的观点。该分析描述了该技术的影响、使用该设备的积极和消极方面，以及参与者的期望、希望和焦虑。结果：参与者为成人32人，年龄38.6±9.6岁，男性占55%；儿童26人，平均年龄12岁（6-18岁），男性占54%。DTQ结果表明，开放和闭环干预的影响和满意度都是适度的，但几乎没有证据表明两者都有比较优势。关键的积极主题包括改善血糖控制，改善总体健康状况，特别是在醒来时，改善睡眠，减轻糖尿病负担，以及数据的可见性。主要的负面主题包括不得不随身携带设备，不喜欢泵和插入的第二个套管（即传感器）。结论：总体而言，参与者报告了闭环技术的积极体验。结果与之前的研究一致，设备的大小仍然是一个问题。在闭环系统的可用性方面正在取得进展。
OBJECTIVE: The objective was to explore psychosocial experiences of closed loop technology for adults, children, and adolescents with type 1 diabetes and their parents taking part in two multicenter, free-living, randomized crossover home studies.METHODS: Participants using insulin pump therapy were randomized to either 12 weeks of automated closed-loop glucose control, then 12 weeks of sensor augmented insulin pump therapy (open loop), or vice versa. Closed loop was used for 24 hours by adults and overnight only by children and adolescents. Participants completed the Diabetes Technology Questionnaire (DTQ) periodically and shared their views in semistructured interviews. This analysis characterizes the impact of the technology, positive and negative aspects of living with the device, alongside participants' expectations, hopes, and anxieties.RESULTS: Participants were 32 adults, age 38.6 ± 9.6 years, 55% male, and 26 children, mean age 12 years (range 6-18 years), 54% male. DTQ results indicated moderately favorable impact of, and satisfaction with, both open and closed loop interventions, but little evidence of a comparative advantage of either. Key positive themes included perceived improved blood glucose control, improved general well-being, particularly on waking, improved sleep, reduced burden of diabetes, and visibility of data. Key negative themes included having to carry around the equipment and dislike of the pump and second cannula (ie, sensor) inserted.CONCLUSIONS: Overall, participants reported a positive experience of the closed loop technology. Results are consistent with previous research with size of equipment continuing to be a problem. Progress is being made in the usability of the closed-loop system.