Learning to Close the Loop

Abstract

The Do-It-Yourself (DIY) Artificial Pancreas System (APS) community is growing very rapidly. Initially the community was composed of members with expertise in coding and other aspects of computing. It now includes a significant proportion of members without such expertise. Building and operating a DIY APS is a complex task that, in contrast to longer established and FDA-approved therapies, is not supported by Health Care Practitioners. In the absence of professional support, how do novices learn to build and maintain a DIY APS? Objective: To identify the key enabling and constraining factors associated with learning to build and operate a DIY APS. Method: A Participatory Action Research approach was used. Key members of the DIY APS community were consulted in developing this study about learning in relation to DIY APS. In-depth, semi-structured interviews were conducted with 10 users of DIY APS who had built their systems in 2017. The participants in this first cohort were from multiple countries. All were adult (18+) type 1 diabetics. A thematic analysis of the interview transcripts was undertaken. Results: Five key themes were identified. 1) Learning was a continuation and deepening of participants’ previous peer-to-peer learning. 2) Persistence was central to all participants’ learning. 3) Learning was enmeshed with emotional and social support from the DIY APS community. 4) Learning challenges varied considerably between individuals and different DIY systems. 5) Learning extended beyond acquiring technical skills to incorporate the collaborative, ‘pay-it-forward’ ethos of the DIY APS community. Conclusion: Preliminary findings suggest that learning in this technologically complex field is facilitated by social and relational practices between peers. Commercial and DIY hybrid and closed loop APSs will become increasingly common: it is therefore important to consider how people with diabetes learn to operate these systems, including the potential of peer-to-peer learning. Disclosure H. Crocket: None.