Endocrine Research Society

Insulin pump therapy is a well-recognized method for treating patients with diabetes. Unlike treatment regimens that employ multiple daily insulin injections and a depot of long-acting insulin to address background insulin needs (basal insulin), insulin pumps deliver small amounts of rapid acting insulin continuously into the subcutaneous tissue through an insulin pump site.

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As the technology surrounding diabetes treatment has improved remarkably over the last few decades, the number of options for diabetes management have also increased. For many, these advances in care have shown improvements in health outcomes (e.g. increased time in target range, decreased HbA1c, etc.) as well as in one’s quality of life (e.g. routine flexibility). However, this phase of rapid innovation in diabetes care can be difficult for some as re-adjustment of daily lifestyle routines may be necessary. Hybrid (also known as partial) closed-loop therapy is one innovation driving a shift in diabetes care towards automated care. In the current literature, there are some studies examining glycemic control and the psychological impact of hybrid closed loop over short periods of time (e.g. several days to several weeks). However, data regarding the transition period from usual pump therapy to hybrid closed loop in a realistic, community setting is lacking. It is the clinical experience of the study investigators that patients with type 1 diabetes using insulin pump therapy experience a period of adjustment as they adopt and integrate new technology such as a novel pump start, a pump upgrade to a newer model, or integration of continuous glucose monitoring (CGM) sensors with pump therapy. Learning to navigate and building trust in their new pump technology remains to be a significant challenge for many.

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Our studies aim to assess and characterize the patient experience during their adjustment period with hybrid closed loop (HCL) systems and associated technologies.