Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;40(5):e15072.
doi: 10.1111/dme.15072. Epub 2023 Mar 7.

Healthcare professionals' views about how pregnant women can benefit from using a closed-loop system: Qualitative study

Julia Lawton  1 , David Rankin  1 , Sara Hartnell  2 , Tara Lee  3   4 , Anna R Dover  5 , Rebecca M Reynolds  5   6 , Roman Hovorka  7   8 , Helen R Murphy  2   3   4 , Ruth I Hart  1 ; AiDAPT Collaborative Group
Affiliations

Healthcare professionals' views about how pregnant women can benefit from using a closed-loop system: Qualitative study

Julia Lawton et al. Diabet Med. 2023 May.

Abstract

Background: Interest is growing in how closed-loop systems can support attainment of within-target glucose levels amongst pregnant women with type 1 diabetes. We explored healthcare professionals' views about how, and why, pregnant women benefitted from using the CamAPS FX system during the AiDAPT trial.

Methods: We interviewed 19 healthcare professionals who supported women using closed-loop during the trial. Our analysis focused on identifying descriptive and analytical themes relevant to clinical practice.

Results: Healthcare professionals highlighted clinical and quality-of-life benefits to using closed-loop in pregnancy; albeit, they attributed some of these to the continuous glucose monitoring component. They emphasised that the closed-loop was not a panacea and that, to gain maximum benefit, an effective collaboration between themselves, the woman and the closed-loop was needed. Optimal performance of the technology, as they further noted, also required women to interact with the system sufficiently, but not excessively; a requirement that they felt some women had found challenging. Even where healthcare professionals felt that this balance was not achieved, they suggested that women had still benefitted from using the system. Healthcare professionals reported difficulties predicting how specific women would engage with the technology. In light of their trial experiences, healthcare professionals favoured an inclusive approach to closed-loop rollout in routine clinical care.

Conclusions: Healthcare professionals recommended that closed-loop systems be offered to all pregnant women with type 1 diabetes in the future. Presenting closed-loop systems to pregnant women and healthcare teams as one pillar of a three-party collaboration may help promote optimal use.

Keywords: closed-loop system; continuous glucose monitoring; healthcare professionals; pregnancy; qualitative research; technology; type 1 diabetes.

PubMed Disclaimer

Conflict of interest statement

SH reports: receiving speaker & advisory board fees from Dexcom, Medtronic, Sanofi and Ypsomed; and being Director of ASK Diabetes Ltd., which receives consulting/training fees from CamDiab Ltd. RH reports: receiving speaker honoraria from Eli Lilly, Dexcom and Novo Nordisk; receiving license and/or consultancy fees from B. Braun and Abbott Diabetes Care; patents related to closed‐loop; and being Director at CamDiab. HRM sits on the Medtronic European Scientific Advisory Board and reports receiving speaker honoraria from Dexcom, Abbott, Medtronic and Novo Nordisk. JL, DR, TL, ARD, RMR, and RIH have no conflicts of interest to declare.

References

    1. Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019;42(8):1593‐1603. - PMC - PubMed
    1. Murphy HR, Bell R, Cartwright C, et al. Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic‐to‐clinic variations: a prospective nationwide study. Diabetologia. 2017;60(9):1668‐1677. - PMC - PubMed
    1. Garcia‐Patterson A, Gich I, Amini SB, Catalano PM, de Leiva A, Corcoy R. Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction. Diabetologia. 2010;53(3):446‐451. - PubMed
    1. Murphy HR, Rayman G, Lewis K, et al. Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. BMJ. 2008;337:a1680. - PMC - PubMed
    1. Feig DS, Donovan LE, Corcoy R, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet. 2017;390(10110):2347‐2359. - PMC - PubMed

Publication types

LinkOut - more resources