Thomas S. Crabtree, United Kingdom
Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust Diabetes & EndocrinololgyPresenter of 1 Presentation
INSIGHTS INTO DO-IT-YOURSELF ARTIFICIAL PANCREAS SYSTEM USER EXPECTATIONS AND CONCERNS PRIOR TO COMMENCEMENT: INTERIM ANALYSIS
Abstract
Background and Aims
There are a growing number of Do-It-Yourself Artificial Pancreas Systems in the UK. These systems are unregulated and unapproved: exploring the perceived benefits, concerns and expectations of people with diabetes prior to using DIY APS; specifically the perceived response of their healthcare teams and any potential safety concerns is important.
Methods
A healthcare professional (HCP) and DIY-APS community collaborativley designed survey was distributed to users during UK “build sessions”.
Results
Twenty-seven responses were received (100% return) from two “build sessions”. Over half (59.3%,16/27) were female, mean age 35.7years (18.5%, 5/27), median diabetes duration 23 years (IQR 11.3-30.0) and median duration of pump therapy 60months (IQR 30-109). Almost all (25/27) pumps were NHS-funded. Half (51.9%, 14/27) were using FreeStyle Libre (FSL) +MiaoMiao, only 2 FSL were not NHS-funded. Important driving factors were “reduced time spent thinking about diabetes” (81.5%,22/27); improved glycaemic control (63%, 17/27) and reducing future complications (63%, 17/27). On a 7-point Likert (1=Very concerned), 5/27 (18.5%) users were at least somewhat (<4) concerned about both a negative HCP response or decreased NHS support. Concerns around safety (2/27, 7.4%) or lack of regulation (1/17, 3.7%) were less common. Even so, 74% (20/27) had informed their HCPs that they were planning to start DIY APS, one of which was perceived as unsupportive.
Conclusions
Perceived potential benefits outweigh regulatory or safety concerns. Users have concerns about the impact on their relationships with HCPs. This survey provides novel insights into user expectations prior to commencing DIY-APS and highlights the ongoing ethical challenges for users and HCPs alike.