1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia.
2 Department of Industrial Engineering, Clemson University , Clemson, South Carolina.
Diabetes Technol Ther. 2017 Nov;19(11):660-674. doi: 10.1089/dia.2017.0150. Epub 2017 Aug 30.
Artificial pancreas (AP) systems have initially been designed for and tested in teens and adults, but there is evidence that an AP system with additional support and safety systems could greatly benefit younger children with type 1 diabetes (T1D).
Five pediatric endocrinologists and 15 parents of children aged 5-8 years with T1D participated in a total of four focus groups. Focus groups investigated current diabetes technology use and acceptance, as well as possible modifications to the current adult AP system, which would allow for safe and successful use in younger children. Modifications discussed include child-specific functionality for input tasks, safety features, and monitoring capabilities.
Participant suggestions included the following: passcodes for differential access to AP features by parents, ancillary caregivers, and the child; preset early, intermediate, and advanced child access categories; maximal customization for general and alarm settings; simplified meal screens utilizing the AP' corrective blood glucose (BG) ability; automated exercise mode; spoken and dictated messaging capabilities; emergency contacts; treatment instructions for the child and caregiver; remote monitoring website and application; animated continuous glucose monitor BG trace; gamification, such as rewarding diabetes-friendly behaviors; and comprehensive training of all individuals involved in the child's diabetes care.
Parents and physicians were eager for AP applications to be available for younger children, but stressed that a modified system could better serve this group's needs for safety and improved diabetes-related communication. The diverse and emerging needs of 5-8-year olds require flexible and customizable systems for T1D management.
人工胰腺 (AP) 系统最初是为青少年和成年人设计和测试的，但有证据表明，具有额外支持和安全系统的 AP 系统可以使患有 1 型糖尿病 (T1D) 的年幼儿童大大受益。
5 名儿科内分泌学家和 15 名 5-8 岁 T1D 儿童的家长参加了总共 4 次焦点小组。焦点小组调查了当前糖尿病技术的使用和接受情况，以及对当前成人 AP 系统进行可能的修改，以便在年幼儿童中安全且成功地使用。讨论的修改包括针对输入任务、安全功能和监测功能的特定于儿童的功能；预设早期、中期和高级儿童访问类别；最大程度地定制一般和报警设置；利用 AP 校正血糖 (BG) 能力简化用餐屏幕；自动化运动模式；语音和口述消息功能；紧急联系人；针对儿童和护理人员的治疗说明；远程监测网站和应用程序；动画连续血糖监测器 BG 轨迹；游戏化，例如奖励糖尿病友好行为；以及对参与儿童糖尿病护理的所有人员进行全面培训。
家长和医生渴望为年幼的孩子提供 AP 应用程序，但强调需要修改后的系统更好地满足这一群体对安全和改善糖尿病相关沟通的需求。5-8 岁儿童的多样化和新兴需求需要灵活和可定制的 T1D 管理系统。
