What question did this study set out to answer?

This analysis aims to explore factors influencing the appeal and uptake of hybrid closed-loop insulin delivery among adults with type 1 diabetes.

June 7, 2026

1627-P: A Qualitative Analysis of Factors Influencing the Appeal of Hybrid Closed-Loop Insulin Delivery among Adults with Type 1 Diabetes

Key Points

This analysis aims to explore factors influencing the appeal and uptake of hybrid closed-loop insulin delivery among adults with type 1 diabetes.
Conducted semi-structured interviews with 9 adults with type 1 diabetes who declined or discontinued hybrid closed-loop systems.
Participants included 66.7% females, median age of 55 years, with a median diabetes duration of 27 years.
Device usability barriers included perceived burdens and the need for manual input.
Factors like form, visibility, and trust in technology affected the appeal and usage decision for hybrid closed-loop systems.
Some participants expressed changing attitudes towards hybrid closed-loop systems based on personal circumstances and management burden.

Abstract

Introduction and Objective: A national programme to provide publicly funded access to hybrid closed-loop (HCL) systems for adults with type 1 diabetes (T1D) has recently been introduced in England and Wales. Despite meeting funding criteria and availability of tubeless options, a number of adults do not utilise HCL. We aimed to explore reasons why. Methods: Semi-structured interviews were conducted with adults with T1D who declined or discontinued HCL despite meeting funding criteria. Results: 9 adults participated; 66.7% female, median age 55 44,66 years, median duration of diabetes 27 15,39 years, mean HbA1c (%) 9.1±3.7. 8 had declined HCL and 1 discontinued. Device usability was a barrier to HCL use, including the perceived burden of change “I’d better stick to what I’m used to” and the need for manual input. Form factor influenced appeal, with a preference for fewer or less intrusive devices “the tube is an absolute no”. Visibility reduced appeal through cognitive discomfort “I would hate it if someone noticed something different”, and reminders of illness “it makes you feel more ill”. “Fear of device malfunction” reduced trust in technology that reduced appeal for some and contributed to HCL discontinuation. The impact of diabetes on current life shaped appeal; some expressed temporal acceptance related to pregnancy planning or shifting life priorities “I’d say OK when visibility no longer a priority” and those with a low daily management burden questioned the value of change. Improved understanding of HCL among some of these individuals, and some with higher daily burden increased appeal of HCL during the interview. Conclusion: Preliminary findings indicate that usability, design, trust, and understanding influence HCL uptake when access is not a limiting factor. Findings reinforce that psychosocial factors and personalised education are essential for informed decision-making. Ongoing analyses will further define barriers to HCL uptake to inform educational strategies and approaches to addressing psychosocial factors. Disclosure A. Anandhakrishnan: None. C. Woombs: None. M. Holloway: Research Support; Current; Dexcom, Inc. Consultant; Ended; Insulet Corporation, Children with Diabetes, Inc. K. Barnard-Kelly: Research Support; Current; Abbott Diabetes, Dexcom, Inc. S. Hussain: Advisory Panel; Ended; Medtronic. Speaker's Bureau; Ended; Dexcom, Inc., Abbott, Insulet Corporation. Advisory Panel; Ended; Tandem Diabetes Care, Inc. Speaker's Bureau; Ended; Lilly. Consultant; Ended; Roche Diabetes Care.

Ask AI

Helpful

Bookmark