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. 2020 Mar;14(2):290-296.
doi: 10.1177/1932296819835183. Epub 2019 Mar 12.

A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

Cari Berget  1 , Sarah E Thomas  1 , Laurel H Messer  1 , Katelin Thivener  1 , Robert H Slover  1 , R Paul Wadwa  1 , G Todd Alonso  1
Affiliations

A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

Cari Berget et al. J Diabetes Sci Technol. 2020 Mar.

Abstract

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D).

Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey.

Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly.

Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.

Keywords: hybrid closed loop; patient education; pediatrics; quality improvement; type 1 diabetes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: CB has received consulting fees from Insulet Corporation and is a contracted product trainer with Medtronic. SET has no relevant disclosures. LHM is a contracted product trainer with Medtronic and has received consulting fees from Tandem Diabetes, Clinical Sensors, and Capillary Biomedical. KT has no relevant disclosures. RHS received research support and funding from Medtronic. RPW has received speaking honoraria from Dexcom, serves on an advisory board for Eli Lilly and Novo Nordisk, and receives research support and funding from Bigfoot Biomedical, Dexcom, Mannkind, and Novo Nordisk. GTA has no relevant disclosures.

Figures

Figure 1.
Figure 1.
Phases of hybrid closed loop training program.
See this image and copyright information in PMC

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