Psychosocial and Human Factors During a Trial of a Hybrid Closed Loop System for Type 1 Diabetes Management
Publication: Diabetes Technology & Therapeutics
Volume 20, Issue Number 10
Abstract
Background: Hybrid closed loop (HCL) systems are designed to automate insulin delivery to improve type 1 diabetes (T1D) outcomes and reduce user burden and distress. Because the systems only automate some aspects of diabetes care, psychosocial and human factors remain an important consideration in their use. Thus, we examined whether psychosocial and human factors (i.e., distress related to diabetes management, fear of hypoglycemia, and technology attitudes) would (1) change after using the system and (2) predict glycemic outcomes during the trial.
Subjects and Methods: Fourteen adults and 15 adolescents with T1D participated in a multisite clinical trial of an investigational version of the MiniMed™ 670G system (Medtronic, Northridge, CA) over 4 to 5 days in a semisupervised outpatient setting. Users completed surveys assessing psychosocial and human factors before beginning the HCL system and at the conclusion of the study. t-Tests and regression analyses were conducted to examine whether these factors changed following trial exposure to the HCL system and predicted glycemic outcomes during the trial.
Results: Diabetes management distress decreased and diabetes technology attitudes became more positive over the trial period. Fear of hypoglycemia did not change over the trial period. There was a trend toward greater pretrial management distress predicting less time in range during the trial, controlling for time in range before the trial.
Conclusions: Results suggest that this system is promising for enhancing technology attitudes and reducing management distress. Psychosocial factors, such as management distress, may negatively impact glycemic outcomes and should be a priority area for further investigation.
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Information & Authors
Information
Published In

Diabetes Technology & Therapeutics
Volume 20 • Issue Number 10 • October 2018
Pages: 648 - 653
PubMed: 30239219
Copyright
Copyright 2018, Mary Ann Liebert, Inc., publishers.
History
Published in print: October 2018
Published online: 26 September 2018
Published ahead of print: 21 September 2018
Topics
Authors
Author Disclosure Statement
S.A.W. is a speaker for Medtronic and his institution has received research funding from Medtronic. He is a speaker for Tandem and Insulet and has served on advisory boards for Sanofi and Zealand Pharmaceuticals. D.M.M. is on the advisory board for Insulet and his institution has received research funding from Medtronic and DexCom. B.A.B. is on medical advisory boards for Sanofi, Novo-Nordisk, BD, UnoMedical, and Medtronic and has received research grant and/or material support from Medtronic, DexCom, LifeScan, Roche, Bayer, UnoMedical, and Tandem. T.T.L. has received honoraria from Medtronic. K.K.H. has served as a consultant to Bigfoot Biomedical and received research support from DexCom. R.N.A., M.L.T., S.J.H., J.M.A, N.W., and D.N. report no potential conflicts of interest relevant to this article.
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