Rollout of closed-loop technology to pregnant women with type 1 diabetes: healthcare professionals’ views about potential challenges and solutions

Rankin, D. et al. (2023) Rollout of closed-loop technology to pregnant women with type 1 diabetes: healthcare professionals’ views about potential challenges and solutions. Diabetes Technology and Therapeutics, 25(4), pp. 260-269. (doi: 10.1089/dia.2022.0479) (PMID:36662589) (PMCID:PMC10066772)

Abstract

Aims: To explore healthcare professionals’ views about the training and support needed to rollout closed-loop technology to pregnant women with type 1 diabetes. Methods: We interviewed (n=19) healthcare professionals who supported pregnant women using CamAPS FX closed-loop during the AiDAPT trial. Data were analysed descriptively. An online workshop involving (n=15) trial team members was used to inform recommendations. Results: Interviewees expressed enthusiasm for a national rollout of closed-loop, but anticipated various challenges, some specific to use during pregnancy. These included variations in insulin pump and continuous glucose monitoring expertise and difficulties embedding and retaining key skills, due to the relatively small numbers of pregnant women using closed-loop. Inexperienced staff also highlighted difficulties interpreting data downloads. To support rollout, interviewees recommended providing expert initial advice training, delivered by device manufacturers together with online training resources and specific checklists for different systems. They also highlighted a need for 24-hour technical support, especially when supporting technology naïve women after first transitioning onto closed-loop in early pregnancy. They further recommended providing case-based meetings and mentorship for inexperienced colleagues, including support interpreting data downloads. Interviewees were optimistic that if healthcare professionals received training and support, their longer-term workloads could be reduced because closed-loop lessened women’s need for glycaemic management input, especially in later pregnancy. Conclusions: Interviewees identified challenges and opportunities to rolling-out closed-loop and provided practical suggestions to upskill inexperienced staff supporting pregnant women using closed-loop. A key priority will be to determine how best to develop mentorship services to support inexperienced staff delivering closed-loop.

• Item Type: Articles
• Additional Information: This project (NIHR 16/35/01) is funded by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership. Additional support for the artificial pancreas work has been provided by the National Institute for Health Research Cambridge Biomedical Research Centre, JDRF, and Wellcome Strategic Award (100574/Z/12/Z).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lindsay, Dr Robert
• Authors: Rankin, D., Hart, R. I., Kimbell, B., Barnard-Kelly, K., Brackenridge, A., Byrne, C., Collett, C., Dover, A. R., Hartnell, S., Hunt, K. F., Lee, T. T.M., Lindsay, R. S., McCance, D. R., McKelvey, A., Rayman, G., Reynolds, R. M., Scott, E. M., White, S. L., Hovorka, R., Murphy, H. R., and Lawton, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Diabetes Technology and Therapeutics
• Publisher: Mary Ann Liebert
• ISSN: 1520-9156
• ISSN (Online): 1557-8593
• Published Online: 20 January 2023
• Copyright Holders: Copyright © 2023 David Rankin et al.
• First Published: First published in Diabetes Technology and Therapeutics 25(4): 260-269
• Publisher Policy: Reproduced under a Creative Commons License