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Why #wearenotwaiting-motivations and self-reported outcomes among users of open-source automated insulin delivery systems: Multinational survey

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journal contribution
posted on 01.06.2021, 00:00 authored by K Braune, K A Gajewska, A Thieffry, D M Lewis, T Froment, S O'Donnell, Jane SpeightJane Speight, Christel HendrieckxChristel Hendrieckx, Jasmine Leigh SchippJasmine Leigh Schipp, T Skinner, H Langstrup, A Tappe, K Raile, B Cleal

Background
Automated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular.


Objective
This study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID.


Methods
A cross-sectional web-based survey was conducted to assess personal motivations and associated self-reported clinical outcomes.


Results
Of 897 participants from 35 countries, 80.5% (722) were adults with diabetes and 19.5% (175) were caregivers of children with diabetes. Primary motivations to commence open-source AID included improving glycemic outcomes (476/509 adults, 93.5%, and 95/100 caregivers, 95%), reducing acute (443/508 adults, 87.2%, and 96/100 caregivers, 96%) and long-term (421/505 adults, 83.3%, and 91/100 caregivers, 91%) complication risk, interacting less frequently with diabetes technology (413/509 adults, 81.1%; 86/100 caregivers, 86%), improving their or child’s sleep quality (364/508 adults, 71.6%, and 80/100 caregivers, 80%), increasing their or child’s life expectancy (381/507 adults, 75.1%, and 84/100 caregivers, 84%), lack of commercially available AID systems (359/507 adults, 70.8%, and 79/99 caregivers, 80%), and unachieved therapy goals with available therapy options (348/509 adults, 68.4%, and 69/100 caregivers, 69%). Improving their own sleep quality was an almost universal motivator for caregivers (94/100, 94%). Significant improvements, independent of age and gender, were observed in self-reported glycated hemoglobin (HbA1c), 7.14% (SD 1.13%; 54.5 mmol/mol, SD 12.4) to 6.24% (SD 0.64%; 44.7 mmol/mol, SD 7.0; P<.001), and time in range (62.96%, SD 16.18%, to 80.34%, SD 9.41%; P<.001).


Conclusions
These results highlight the unmet needs of people with diabetes, provide new insights into the evolving phenomenon of open-source AID technology, and indicate improved clinical outcomes. This study may inform health care professionals and policy makers about the opportunities provided by open-source AID systems.


International Registered Report Identifier (IRRID)
RR2-10.2196/15368

History

Journal

Journal of Medical Internet Research

Volume

23

Issue

6

Article number

e25409

Pagination

1 - 17

Publisher

JMIR Publications Inc.

Location

Toronto, Ont.

ISSN

1438-8871

eISSN

1438-8871

Language

English

Publication classification

C1 Refereed article in a scholarly journal