Cambridge hybrid closed‐loop use in very young children with type 1 diabetes: Parental expectancies during long‐term home use

Aims To examine parental expectancies regarding automated insulin delivery (AID) during extended home use of CamAPS FX hybrid closed‐loop (HCL) in very young children with type 1 diabetes (T1D). Methods Parents of 64 young children aged 1–7 with T1D participated in a multinational randomised crossover trial and an 18‐month HCL extension phase. Glycaemic outcomes (HbA1c) were recorded, and parental expectancies were assessed using the INSPIRE questionnaire, which evaluates parents' perceptions and expectations of AID systems. Assessments were conducted at baseline, during the HCL clinical trial phase and after the 18‐month extension phase in the home environment. Linear mixed models were used to analyse outcomes across time. Results HCL use during the clinical trial phase improved HbA1c (baseline: 56.03 ± 7.31 mmol/mol [7.3%] vs. clinical trial: 50.78 ± 6.90 [6.8%]; p < 0.001), with benefits sustained over the 18‐month extension period (49.00 ± 6.63 [6.8%]; p = 0.45). Parental expectancies did not change during the clinical trial phase (baseline: 44.78 ± 34.70 vs. clinical trial: 42.10 ± 38.11; p = 0.629, d = 0.05) but increased markedly after 18 months of home use (89.83 ± 9.35; p < 0.001, d = 1.14). Conclusions Prolonged HCL use supports sustained glycaemic benefits while parental positive expectancies regarding AID increase over time. These findings suggest that parental trust develops through experience‐dependent adaptation shaped by the combination of stable glycaemic outcomes and sustained real‐world use and is important for continued engagement with AID. Clinical Trial Registration: NCT03784027; ClinicalTrials.gov