Women’s and Partners’ Experiences with a Closed-Loop Insulin Delivery System to Manage Type 1 Diabetes in the Postpartum Period

Abstract

Closed-loop insulin delivery has the potential to offer women with type 1 diabetes a break from intense diabetes self-care efforts during postpartum. To explore the views and opinions of hybrid closed-loop users and their partners in the first 24 weeks postpartum. This qualitative study was embedded in a controlled study of women with type 1 diabetes randomized to (MiniMed™ 670G/770G) closed-loop insulin delivery or sensor augmented pump use 1-11 weeks 6 days postpartum, with all on closed-loop from 12 to 24 weeks postpartum. Semi-structured interviews were conducted with 16 study participants and their partners at 12 and 24 weeks postpartum. Thematic analyses were used to examine participants' and partners' experiences. Participants' positive perceptions of the closed-loop use related to reduced hypoglycemia, in contrast to previous experiences with nonautomated insulin delivery. These were balanced against frustrations with the system allowing blood glucose levels to be above what they desired. Closed-loop use did not influence infant feeding choice. Yet, infant feeding and care impacted participants' diabetes management. Partners expressed uncertainty about the closed-loop taking away control from participants who were highly skilled with diabetes self-management. Participants reported that the closed-loop resulted in less time spent in hypoglycemia; compared to previously used nonautomated insulin delivery. Yet, participants desired greater understanding into the workings of the closed-loop algorithm. This study provides potential users with realistic expectations about the user experience with the MiniMed™ 670G/770G closed-loop in the postpartum period.