929-P: Adaptive Therapy Settings—Qualitative Insights from People with Type 1 Diabetes Using Multiple Daily Injections Transitioning to an Automated System

Abstract

Thirty adults with T1D using multiple daily injections (MDI) participated in a prospective single center 13-week study using an advanced hybrid closed-loop (HCL) system (Control-IQ Technology, Tandem Diabetes Care). In addition to advanced HCL, the system included a novel algorithm to accurately initialize insulin delivery settings and adapt them over time. Adaptation recommendations were generated by analyzing uploaded pump data and sent to study providers for safety review. Study results showed reduced hypoglycemia and immediate and sustained improvement in time in range. Here we report on six semi-structured 1-on-1 interviews with participants completed at end of study. Each interview lasted ~30 minutes using a script of open-ended questions to gather feedback and reactions to the use of advanced HCL as well as trust and confidence in the automated therapy settings recommendations. All participants reported a positive experience, particularly due to improved glucose control, relief from the burden of managing glucose, improved sleep, and overall better quality of life. Participants were generally confident with the settings that were recommended to them, and while 2 of the 6 participants questioned some therapy suggestions, they were comfortable enough with the recommended changes and felt in the end they had well-tuned therapy settings. One participant expressed hesitation about automating the settings, but this was ameliorated by education about how the algorithm worked and knowing how to stop the automated updates if needed. Two participants mentioned struggling with hypoglycemia due to exercise. All 6 participants wanted to transition from MDI to pump therapy after completing the trial. These qualitative insights reaffirm that algorithm driven workflows must result in outcomes that instill user trust in the system. Disclosure S.Habif: Employee; Tandem Diabetes Care, Inc. J.E.Pinsker: Employee; Tandem Diabetes Care, Inc. L.H.Messer: Advisory Panel; Lilly, Consultant; Dexcom, Inc., Capillary Biomedical, Inc., Employee; Tandem Diabetes Care, Inc., Research Support; Beta Bionics, Inc., Medtronic, Insulet Corporation. E.Schertz: Employee; Tandem Diabetes Care, Inc. A.Trahan: Employee; Tandem Diabetes Care, Inc. A.Constantin: Employee; Tandem Diabetes Care, Inc. A.Wheatcroft: Employee; Tandem Diabetes Care, Inc. K.N.White: Employee; Tandem Diabetes Care, Inc. N.J.Piquette: Employee; Tandem Diabetes Care, Inc. K.Carmelo: Employee; Tandem Diabetes Care, Inc. R.Katchalski: Employee; Tandem Diabetes Care, Inc. Funding Tandem Diabetes Care, Inc.