倾听女性的声音:闭环系统在 1 型糖尿病妊娠中的应用体验。
Listening to Women: Experiences of Using Closed-Loop in Type 1 Diabetes Pregnancy.
机构信息
Usher Institute, Medical School, University of Edinburgh, Edinburgh, United Kingdom.
Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, United Kingdom.
出版信息
Diabetes Technol Ther. 2023 Dec;25(12):845-855. doi: 10.1089/dia.2023.0323. Epub 2023 Nov 7.
Recent high-profile calls have emphasized that women's experiences should be considered in maternity care provisioning. We explored women's experiences of using closed-loop during type 1 diabetes (T1D) pregnancy to inform decision-making about antenatal rollout and guidance and support given to future users. We interviewed 23 closed-loop participants in the Automated insulin Delivery Among Pregnant women with T1D (AiDAPT) trial after randomization to closed-loop and ∼20 weeks later. Data were analyzed thematically. Women described how closed-loop lessened the physical and mental demands of diabetes management, enabling them to feel more normal and sleep better. By virtue of spending increased time-in-range, women also worried less about risks to their baby and being judged negatively by health care professionals. Most noted that intensive input and support during early pregnancy had been crucial to adjusting to, and developing confidence in, the technology. Women emphasized that attaining pregnancy glucose targets still required ongoing effort from themselves and the health care team. Women described needing education to help them determine when, and how, to intervene and when to allow the closed-loop to operate without interference. All women reported more enjoyable pregnancy experiences as a result of using closed-loop; some also noted being able to remain longer in paid employment. Study findings endorse closed-loop use in T1D pregnancy by highlighting how the technology can facilitate positive pregnancy experiences. To realize fully the benefits of closed-loop, pregnant women would benefit from initial intensive oversight and support together with closed-loop specific education and training. Clinical Trial Registration number: NCT04938557.
最近备受瞩目的呼吁强调,在提供产妇护理时应考虑女性的体验。我们探讨了女性在 1 型糖尿病 (T1D) 妊娠期间使用闭环系统的体验,以告知关于产前推广的决策,并为未来的使用者提供指导和支持。我们在 AiDAPT 试验中对随机分配至闭环系统的 23 名闭环系统参与者进行了访谈,时间是随机分配后约 20 周。数据进行了主题分析。女性描述了闭环系统如何减轻糖尿病管理的身体和心理需求,使她们感觉更正常、睡眠更好。由于在目标范围内的时间增加,女性也更少担心对婴儿的风险,并且较少受到医疗保健专业人员的负面评价。大多数人指出,在妊娠早期接受强化的输入和支持对于适应和建立对技术的信心至关重要。女性强调,要实现妊娠血糖目标,仍然需要她们自己和医疗团队的持续努力。女性描述说,需要接受教育,以帮助她们确定何时、如何进行干预,以及何时允许闭环系统在没有干扰的情况下运行。所有女性都报告说,由于使用闭环系统,妊娠体验更加愉快;一些女性还指出,她们能够更长时间地从事有薪工作。研究结果通过强调该技术如何促进积极的妊娠体验,支持在 T1D 妊娠中使用闭环系统。为了充分实现闭环系统的益处,孕妇将受益于初始的强化监督和支持,以及闭环系统的特定教育和培训。临床试验注册号:NCT04938557。
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