Reduced burden of diabetes and improved quality of life: Experiences from unrestricted day‐and‐night hybrid closed‐loop use in very young children with type 1 diabetes

• DOI: 10.1111/pedi.12872
• Publication Date: 2019-05-29T11:35:18Z
• Authors: Gianluca Musolino; Klemen Dovc; Charlotte K. Boug...; Martin Tauschmann; Janet M. Allen; Katrin Nagl; Maria Fritsch; James Yong; Emily Metcalfe; Dominique Schaeffer; Muriel Fichelle; Ulrike Schierloh; Alena G. Thiele; Daniela Abt; Harald Kojzar; Julia K. Mader; Sonja Slegtenhorst; Nicole Ashcroft; Malgorzata E. Wil...; Judy Sibayan; Nathan Cohen; Craig Kollman; Sabine E. Hofer; Elke Fröhlich‐Rei...; Thomas M. Kapellen; Carlo L. Acerini; Carine de Beaufort; Fiona Campbell; Birgit Rami‐Merhar; Roman Hovorka
• Keywords: Blood Glucose; Male; Parents; Child, preschool; type 1 diabetes; very young children; 03 medical and health sciences; Blood Glucose/drug effects; Caregivers/psychology; Insulin Infusion Systems; 0302 clinical medicine; Cost of Illness; Surveys and Questionnaires; Psychological Aspects of Diabetes; closed-loop insulin delivery; Humans; Insulin; Family; Child; Quality Of Life; Cross-Over Studies; artificial pancreas; Blood Glucose Self-Monitoring; Family/psychology; Infant; Diabetes Mellitus, Type 1/blood; Circadian Rhythm; 3. Good health; Diabetes Mellitus, Type 1; Caregivers; Child, Preschool; Quality of Life; Circadian Rhythm/physiology; Female; Insulin/administration & dosage; Parents/psychology

OBJECTIVE: To evaluate the experiences of families with very young children aged 1 to 7 years (inclusive) with type 1 diabetes using day-and-night hybrid closed-loop insulin delivery. METHODS: Parents/caregivers of 20 children aged 1 to 7 years with type 1 diabetes completed a closed-loop experience survey following two 3-week periods of unrestricted day-and-night hybrid closed-loop insulin therapy using Cambridge FlorenceM system at home. Benefits, limitations, and improvements of closed-loop technology were explored. RESULTS: Responders reported reduced burden of diabetes management, less time spent managing diabetes, and improved quality of sleep with closed-loop. Ninety percent of the responders felt less worried about their child's glucose control using closed-loop. Size of study devices, battery performance and connectivity issues were identified as areas for improvement. Parents/caregivers wished for more options to input information to the system such as temporary glucose targets. CONCLUSIONS: Parents/caregivers of very young children reported important quality of life benefits associated with using closed-loop, supporting adoption of this technology in this population.