Factors influencing the acceptability of automated insulin delivery systems in youths with type 1 diabetes and their parents

• Published in: Diabetes research and clinical practice 2024-12, p.111962, Article 111962
• Main Authors: Franceschi, Roberto, Pertile, Riccardo, Marigliano, Marco, Mozzillo, Enza, Maffeis, Claudio, Zaffani, Silvana, Dusini, Carlotta, Antonelli, Annalisa, Maltoni, Giulio, Candia, Francesca Di, Cantarelli, Erika, Minuto, Nicola, Bassi, Marta, Rabbone, Ivana, Savastio, Silvia, Passanisi, Stefano, Lombardo, Fortunato, Cherubini, Valentino, Saltarelli, Maria Alessandra, Tumini, Stefano
• Format: Article
• Language: English
• Subjects: Acceptability; Automated; Closed-loop systems; Continuous glucose monitoring; Insulin therapy; Pediatrics
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2024.111962

[Display omitted] •Participants with SAP had higher AP-acceptance scores.•The main perceived benefits of AIDs were hyperglycemia control and QoL.•Perceived barriers to AIDs include discomfort, and males seem to feel less of this concern.•Glucose metrics, demographic factors, and diabetes history did not impact AP-acceptance. New technology has been reported as a factor driving people to choose an automatic insulin delivery system (AIDs) and to sustain its acceptance. We aimed to explore the role of continuous glucose monitoring (CGM) technology (instant scanning vs. real-time) and insulin treatment modality to determine the future acceptance of AIDs among T1D individuals. 239 consecutively enrolled T1D youth and their parents returned the AP questionnaire. All individuals were on CGM, using multiple daily injections (MDI) or sensor-augmented pump (SAP) therapy. The AP-acceptance was more than neutral, with mean overall scores of 3.91 ± 0.47 and 3.99 ± 0.43 (p = 0.07), youths and parents, respectively. Domains’ analysis revealed high scores in intention to use, usefulness, and trust in AIDs, with favorable expected judgments by others. The items with the highest overall mean scores revealed high glucose control and QoL benefits; the main hassle was the size and discomfort of wearing two devices. Multivariate analysis found that male gender and SAP therapy were associated with a higher AP-acceptance overall score (p = 0.045, 0.015, 0.0001, respectively). Participants receiving SAP therapy demonstrated higher expectations and optimistic views about AIDs. This treatment modality can act as a trampoline to AIDs despite individuals’ glucose control and diabetes history.