University of Chicago, Pediatric Residency Training Program, Chicago, IL, USA.
University of Chicago, Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Chicago, IL, USA.
J Diabetes Sci Technol. 2020 Sep;14(5):860-867. doi: 10.1177/1932296820942258. Epub 2020 Jul 17.
A growing number of people with diabetes are choosing to adopt do-it-yourself artificial pancreas system (DIYAPS) despite a lack of approval from the US Food and Drug Administration.We describe patients' experiences using DIYAPS, and patient and diabetes providers' perspectives on the use of such technology.
We distributed surveys to patients and diabetes providers to assess each group's perspectives on the use of DIYAPS. The patient survey also assessed glycemic control and impact on sleep. The patient survey was distributed in February 2019 via Facebook and Twitter ( = 101). The provider survey was distributed via the American Association of Diabetes Educators' e-mail newsletter in April 2019 and the Pediatric Endocrine Society membership e-mail list in May 2019 ( = 152).
Patients overwhelmingly described improvements in glycemic control and sleep quality: 94% reported improvement in time in range, and 64% reported improvement in all five areas assessed. Eighty-nine percent of patients described DIYAPS as "Safe" or "Very Safe," compared to only 27% of providers. Most felt encouraged by their diabetes provider to continue using DIYAPS, but few described providers as knowledgeable regarding its use. Providers cited a lack of experience with such systems and an inability to troubleshoot them as their most significant challenges.
Despite evidence that DIYAPS usage is increasing, our surveys suggest that patients' adoption of this technology and trust in it is outpacing that of diabetes providers. Providers must be aware of this growing population of patients and familiarize themselves with DIYAPS to support patients using this technology.
越来越多的糖尿病患者选择使用 DIYAPS(自行人工胰腺系统),尽管该技术尚未获得美国食品和药物管理局的批准。我们描述了患者使用 DIYAPS 的体验,以及患者和糖尿病护理人员对使用此类技术的看法。
我们向患者和糖尿病护理人员分发了调查问卷,以评估每个群体对使用 DIYAPS 的看法。患者调查问卷还评估了血糖控制情况和对睡眠的影响。患者调查问卷于 2019 年 2 月通过 Facebook 和 Twitter 分发(n = 101)。提供者调查问卷于 2019 年 4 月通过美国糖尿病教育者协会的电子邮件时事通讯和 2019 年 5 月的儿科内分泌学会会员电子邮件列表分发(n = 152)。
患者普遍描述了血糖控制和睡眠质量的改善:94%的患者报告时间在范围内的改善,64%的患者报告了所有五个评估领域的改善。89%的患者将 DIYAPS 描述为“安全”或“非常安全”,而只有 27%的提供者这样描述。大多数患者的糖尿病护理人员鼓励他们继续使用 DIYAPS,但很少有提供者表示了解其使用方法。提供者表示,缺乏使用此类系统的经验和无法对其进行故障排除是他们面临的最大挑战。
尽管有证据表明 DIYAPS 的使用正在增加,但我们的调查表明,患者对该技术的采用及其对该技术的信任度超过了糖尿病护理人员。提供者必须意识到这一不断增长的患者群体,并熟悉 DIYAPS,以支持患者使用这项技术。