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

Autor: Jerome Place, Daniela Bruttomesso, Lalo Magni, Eric Renard, J DeJong, Jort Kropff, Mirko Messori, Claudio Cobelli, S. Del Favero, Angelo Avogaro, Silvia Galasso, B Coestier, Federico Boscari, J. H. DeVries, Anne Farret
Přispěvatelé: General Internal Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Adult
Blood Glucose
Male
Pancreas
Artificial
medicine.medical_specialty
Evening
Endocrinology
Diabetes and Metabolism
030209 endocrinology & metabolism
Internal Medicine
Endocrinology
Artificial pancreas
law.invention
03 medical and health sciences
0302 clinical medicine
Patient satisfaction
Insulin Infusion Systems
Randomized controlled trial
Educational and Psychological Aspects
law
Diabetes mellitus
Surveys and Questionnaires
medicine
Humans
Hypoglycemic Agents
Insulin
030212 general & internal medicine
Type 1 diabetes
Cross-Over Studies
business.industry
Research
Fear
Middle Aged
medicine.disease
Crossover study
Hypoglycemia
Surgery
Diabetes and Metabolism
Diabetes Mellitus
Type 1
Research: Educational and Psychological Aspects
Patient Satisfaction
Physical therapy
Female
Analysis of variance
business
Zdroj: Diabetic medicine, 34(2), 262-271. Wiley-Blackwell
Diabetic Medicine
ISSN: 0742-3071
DOI: 10.1111/dme.13268
Popis: 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.
What's new? To our knowledge this is the first study to examine the treatment satisfaction and acceptance of an artificial pancreas system using validated questionnaires and semi‐structured interviews in a long‐ term, randomized crossover trial in people with Type 1 diabetes.Although participant acceptance of the artificial pancreas was high, no improvement in treatment satisfaction was found compared with sensor‐augmented pump therapy. Participants appear to appreciate the positive effects on glucose regulation but technical errors and reduced usability diminish their appreciation for the system.Our results provide further insight into patient acceptance of current artificial pancreas technology and signifies the need for further development of the technology before commercialization.
Databáze: OpenAIRE
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