Department of Pediatrics, Stanford University School of Medicine, CA, USA.
Boston University School of Medicine, MA, USA.
J Diabetes Sci Technol. 2020 Sep;14(5):837-843. doi: 10.1177/1932296820902771. Epub 2020 Feb 5.
Closed loop (CL) automated insulin delivery systems are demonstrated to be safe and effective in regulating glucose levels and reducing cognitive burden in people with type 1 diabetes (T1D). However, given the limited market options and the do-it-yourself nature of most systems, it can be difficult for potential users to shape their expectations fitting them into daily lives and management routines. As such, we examined the potential feasibility of a virtual reality (VR) intervention.
A four-part VR intervention was created to expose adults with T1D to expected CL system barriers: body image, perceived hassles of using CL, deskilling fears, and unwanted social attention. Goals of the pilot were to assess feasibility and expose patients to CL. Surveys were conducted pre- and postparticipating in the VR experience.
A total of 20 adults with T1D completed the pilot. Average time to complete the experience was 14.1 minutes (8.8-39.9). Reported VR sickness was low. Willingness to use VR was maintained in 90% ( = 18) and did not change expectations of CL in 95% ( = 19). Virtual reality changed perceived hassles of CL in 25% ( = 5) with four concerned over alarms and one connectivity issues: positive diabetes technology attitudes, confidence in managing hypoglycemia, overall perceptions of appearance, and positive affect maintained after the VR intervention. Negative affect significantly decreased after exposure and perceptions of being overweight trended toward significance.
This pilot VR intervention demonstrated high potential in addressing expected barriers to uptake and usage of CL systems without decreasing enthusiasm or changing expectations of CL.
闭环（CL）自动胰岛素输送系统已被证明在调节 1 型糖尿病（T1D）患者的血糖水平和减轻认知负担方面是安全有效的。然而，由于市场选择有限，并且大多数系统都是 DIY 性质，潜在用户可能难以根据自己的日常生活和管理常规来调整自己的期望。因此，我们研究了虚拟现实（VR）干预的潜在可行性。
创建了一个四部分的 VR 干预措施，使 T1D 成年人接触到预期的 CL 系统障碍：身体形象、使用 CL 的感知麻烦、技能丧失恐惧和不必要的社会关注。该试验的目的是评估可行性并使患者接触到 CL。在参与 VR 体验前后进行了调查。
共有 20 名 T1D 成年人完成了该试验。完成体验的平均时间为 14.1 分钟（8.8-39.9）。报告的 VR 病发生率较低。90%（ = 18）的人愿意继续使用 VR，95%（ = 19）的人对 CL 的期望没有改变。25%（ = 5）的人认为 VR 改变了他们对 CL 的感知麻烦，其中四人担心警报，一人担心连接问题：对糖尿病技术的积极态度、管理低血糖的信心、对外观的整体看法以及在 VR 干预后积极的情绪都得到了维持。暴露后负面情绪显著下降，超重的看法也趋于显著。
这项 VR 干预试验表明，在解决对 CL 系统的采用和使用的预期障碍方面具有很高的潜力，同时不会降低对 CL 的热情或改变对 CL 的期望。
