دورية أكاديمية
Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation.
| العنوان: | Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation. |
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| المؤلفون: | Wong JJ; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA., Suttiratana SC; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA., Lal RA; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.; Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.; Stanford Diabetes Research Center (SDRC), Stanford University School of Medicine, Stanford, California, USA., Lum JW; Jaeb Center for Health Research, Tampa, Florida, USA., Lanning MS; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA., Dunlap A; Division of Agriculture, Food, and Environment, Friedman School of Nutrition Science and Policy, Tufts University, Medford, Massachusetts, USA., Arbiter B; Tidepool, San Francisco, California, USA., Hanes SJ; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA., Bailey RJ; Jaeb Center for Health Research, Tampa, Florida, USA., Hood KK; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.; Stanford Diabetes Research Center (SDRC), Stanford University School of Medicine, Stanford, California, USA., Naranjo D; Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.; Stanford Diabetes Research Center (SDRC), Stanford University School of Medicine, Stanford, California, USA. |
| المصدر: | Diabetes technology & therapeutics [Diabetes Technol Ther] 2022 Apr; Vol. 24 (4), pp. 241-248. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100889084 Publication Model: Print Cited Medium: Internet ISSN: 1557-8593 (Electronic) Linking ISSN: 15209156 NLM ISO Abbreviation: Diabetes Technol Ther Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1999- |
| مواضيع طبية MeSH: | Diabetes Mellitus, Type 1*/drug therapy , Diabetes Mellitus, Type 1*/psychology , Insulin*/therapeutic use, Blood Glucose ; Blood Glucose Self-Monitoring ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin Infusion Systems/psychology ; Pregnancy |
| مستخلص: | Background: Loop is an open-source automated insulin dosing system that allows users unrivaled control over system settings that affect future glucose prediction. Thousands use Loop, but little is known about those who discontinue. Methods: In a large observational study, 874 Loop participants completed surveys and provided glycemic data, 46 (5.3%) of those self-identified as discontinuing Loop use during the observation window, 45 completed a discontinued use survey, 22 provided system settings data, and 19 participated in semistructured interviews about their discontinuation. Qualitative data were transcribed, coded, and analyzed. Results: Older age and not trusting Loop were associated with discontinued use, although no other demographic or clinical characteristics were significant correlates. The most endorsed reasons were "I decided to try something else" (27.8%) followed by "It just didn't help as much as I thought it would" (22.2%). Qualitative analyses revealed prominent themes centered upon mental and emotional burden and adjusting settings. Other reasons for discontinued use included fear of disapproval of Loop use from diabetes provider, barriers to acquiring component devices, a desire to try new/different technologies, concerns that Loop could not accommodate specific exercise or low insulin dose regimens, and worry about Loop use during pregnancy. It was noted that burdens might be alleviated by enhanced technical assistance and expert guidance. Conclusions: Although the majority of individuals in the Loop observational study continued use, those who discontinued reported similar challenges. Technical support and education specific to setting calculations could expand Loop benefits, alleviate burden, and support sustained use among new Loop users. Clinical Trial Registration: clinicaltrials.gov (NCT03838900). |
| References: | Diabetes Technol Ther. 2021 May;23(5):367-375. (PMID: 33226840) Diabetes Technol Ther. 2021 Aug;23(8):546-554. (PMID: 33720767) Diabetes Care. 2017 Feb;40(2):181-187. (PMID: 27899489) Diabetes Care. 2011 Apr;34(4):801-6. (PMID: 21346182) Diabetes Manag (Lond). 2011;1(6):627-639. (PMID: 22180760) Diabetes Care. 2012 Feb;35(2):259-64. (PMID: 22228744) Ann Fam Med. 2008 May-Jun;6(3):246-52. (PMID: 18474888) Diabetes Care. 2019 Dec;42(12):2190-2196. (PMID: 31548247) Pediatr Diabetes. 2020 Mar;21(2):319-327. (PMID: 31885123) |
| معلومات مُعتمدة: | K12 DK122550 United States DK NIDDK NIH HHS; K23 DK121771 United States DK NIDDK NIH HHS; K23 DK122017 United States DK NIDDK NIH HHS; P30 DK116074 United States DK NIDDK NIH HHS |
| فهرسة مساهمة: | Keywords: Automation; Diabetes mellitus; Insulin/administration and dosage; Type 1/drug therapy |
| سلسلة جزيئية: | ClinicalTrials.gov NCT03838900 |
| المشرفين على المادة: | 0 (Blood Glucose) 0 (Hypoglycemic Agents) 0 (Insulin) |
| تواريخ الأحداث: | Date Created: 20211115 Date Completed: 20220419 Latest Revision: 20230916 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9057870 |
| DOI: | 10.1089/dia.2021.0362 |
| PMID: | 34780283 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1557-8593 |
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| DOI: | 10.1089/dia.2021.0362 |