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Experiences of closed‐loop insulin delivery among pregnant women with Type 1 diabetes
Author(s) -
Farrington C.,
Stewart Z. A.,
Barnard K.,
Hovorka R.,
Murphy H. R.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13406
Subject(s) - medicine , type 1 diabetes , worry , pregnancy , diabetes mellitus , psychosocial , type 2 diabetes , randomized controlled trial , crossover study , feeling , insulin , endocrinology , anxiety , psychiatry , social psychology , alternative medicine , psychology , placebo , pathology , biology , genetics
Aims To explore the experiences of pregnant women with Type 1 diabetes, and the relationships between perceptions of glucose control, attitudes to technology and glycaemic responses with regard to closed‐loop insulin delivery. Methods We recruited 16 pregnant women with Type 1 diabetes [mean ± sd age 34.1 ± 4.6 years, duration of diabetes 23.6 ± 7.2 years, baseline HbA 1c 51±5 mmol/mol (6.8 ± 0.6%)] to a randomized crossover trial of sensor‐augmented pump therapy vs automated closed‐loop therapy. Questionnaires (Diabetes Technology Questionnaire, Hypoglycaemia Fear Survey) were completed before and after each intervention, with qualitative interviews at baseline and follow‐up. Results Women described the benefits and burdens of closed‐loop systems during pregnancy. Feelings of improved glucose control, excitement and empowerment were counterbalanced by concerns about device visibility, obsessive data checking and diminished attentiveness to hyper‐ and hypoglycaemia symptoms. Responding to questionnaires, eight participants felt less worry about overnight hypoglycaemia and that diabetes ‘did not run their lives’; however, five reported that closed‐loop increased time thinking about diabetes, and three felt it made sleep and preventing hyperglycaemia more problematic. Women slightly overestimated their glycaemic response to closed‐loop therapy. Most became more positive in their technology attitudes throughout pregnancy. Women with more positive technology attitudes had higher degrees of overestimation, and poorer levels of glycaemic control. Conclusions Women displayed complex psychosocial responses to closed‐loop therapy in pregnancy. Perceptions of glycaemic response may diverge from biomedical data.