User experiences during the transition to calibration-free sensors with remote monitoring while using automated insulin delivery - a qualitative study

• Published in: Frontiers in endocrinology (Lausanne) 2023-08, Vol.14, p.1214975
• Main Authors: Sehgal, Shekhar, De Bock, Martin, Jones, Shirley, Frewen, Carla, Wheeler, Benjamin J.
• Format: Article
• Language: English
• Subjects: continuous glucose monitoring; Endocrinology; interview; patient satisfaction; remote monitoring; type 1 diabetes mellitus
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2023.1214975

To evaluate the experiences of patients with type 1 diabetes following transition from a calibration-requiring to a calibration-free sensor and remote monitoring in the context of using automated insulin delivery (AID).IntroductionTo evaluate the experiences of patients with type 1 diabetes following transition from a calibration-requiring to a calibration-free sensor and remote monitoring in the context of using automated insulin delivery (AID).Fifteen participants aged 7-65 years with type 1 diabetes participating in a longitudinal study used a Medtronic® advanced hybrid closed loop (AHCL) device with initially calibration-requiring then calibration-free sensors. Qualitative interviews were conducted ≥20 weeks following use of the calibration-requiring and ≥4 weeks after use of the calibration-free sensors/remote monitoring. Thematic analysis was used to identify key themes and subthemes.Research design and methodsFifteen participants aged 7-65 years with type 1 diabetes participating in a longitudinal study used a Medtronic® advanced hybrid closed loop (AHCL) device with initially calibration-requiring then calibration-free sensors. Qualitative interviews were conducted ≥20 weeks following use of the calibration-requiring and ≥4 weeks after use of the calibration-free sensors/remote monitoring. Thematic analysis was used to identify key themes and subthemes.At baseline, mean diabetes duration was 14.5 years ( ± 10.9), mean Hba1c 54.8 mmol/mol ( ± 10.2) (7.2 ± 0.9%) and Time in range 75.4% ( ± 11.6). Participants reported a progressive improvement in digital and lifestyle integration, and device trust following transition to calibration-free sensors with remote monitoring potential. They also reported a reduced need for capillary glucose, increased device satisfaction and trust, and reduced burden of diabetes care. Negative aspects reported included periodic early sensor loss, and for some, impaired integration with mobile devices.ResultsAt baseline, mean diabetes duration was 14.5 years ( ± 10.9), mean Hba1c 54.8 mmol/mol ( ± 10.2) (7.2 ± 0.9%) and Time in range 75.4% ( ± 11.6). Participants reported a progressive improvement in digital and lifestyle integration, and device trust following transition to calibration-free sensors with remote monitoring potential. They also reported a reduced need for capillary glucose, increased device satisfaction and trust, and reduced burden of diabetes care. Negative aspects reported included periodic early sensor los