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

Farrington, C., Stewart, Z. A., Barnard, K., Hovorka, R. and Murphy, H. R. (2017) Experiences of closed-loop insulin delivery among pregnant women with Type 1 diabetes. Diabetic Medicine, 34 (10). 1461–1469. ISSN 0742-3071

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Abstract

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 HbA1c 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, 80% of participants felt less worry about overnight hypoglycaemia and that diabetes ‘did not run their lives’; however, 45% reported that closed-loop increased time thinking about diabetes, and 33% 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.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 04 Jul 2017 05:06
Last Modified: 09 Sep 2020 23:48
URI: https://ueaeprints.uea.ac.uk/id/eprint/63991
DOI: 10.1111/dme.13406

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