Adolescence and kids with type 1 diabetes who use artificial pancreas devices, otherwise known as hybrid closed loop (HCL) systems reported fewer symptoms of diabetes distress according to new findings published in Diabetes Technology & Therapeutics.
The study examined whether psychosocial and human factors such as 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.
How was the Study Conducted?
Fourteen adults and 15 adolescents with type 1 diabetes participated in a clinical trial of an investigational version of the MiniMed™ 670G system over 4 to 5 days in a semisupervised outpatient setting.
Users then completed surveys assessing psychosocial and human factors before beginning the HCL system and at the conclusion of the study.
An analysis was done to examine whether these factors changed following trial exposure to the HCL system and predicted glycemic outcomes during the trial.
The authors acknowledge there were certain limitations to the study. First, they indicate the lack of a control group prevented them from concluding that the HCL system led to the improvements seen in psychosocial and human factors.
Second, the small sample size presented a challenge to researchers for examining the psychosocial and human factors as predictors of glycemic outcomes and precluded examination of group differences between HCL systems, adolescents, and adults.
Third, “participants may have differed from the general population of people with type 1 diabetes, (that is all participants were using either an insulin pump or CGM at baseline and may have more favorable technology attitudes and less distress), which could limit the generalizability of these findings,” the authors write.
They suggest that the findings warrant replication in a larger sample that is more representative.
The fourth limiting factor was the trial lasted only 4 to 5 days, and authors note it’s possible that more change would occur over a longer period of time.
“A longer trial would also provide opportunities to explore whether psychosocial and human factors predict sustained use in addition to glycemic outcomes,” the authors state.
What were the Findings?
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.
“The results suggest that this system is promising for enhancing technology attitudes and reducing management distress,” the authors state in their conclusions.
“Psychosocial factors, such as management distress, may negatively impact glycemic outcomes and should be a priority area for further investigation.
Please see the study for the study authors’ relevant financial disclosures.
The study had been published online: https://doi.org/10.1089/dia.2018.0174
- Rebecca N. Adams, Molly L. Tanenbaum, Sarah J. Hanes, Jodie M. Ambrosino, Trang T. Ly, David M. Maahs, Diana Naranjo, Natalie Walders-Abramson, Stuart A. Weinzimer, Bruce A. Buckingham, and Korey K. Hood.Diabetes Technology & Therapeutics. Oct 2018. http://doi.org/10.1089/dia.2018.0174