Improving the Safety and Functionality of an Artificial Pancreas System for Use in Younger Children: Input from Parents and Physicians

• Published in: Diabetes technology & therapeutics Vol. 19; no. 11; p. 660
• Main Authors: Gildersleeve, Rachel, Riggs, Sara L, Cherñavvsky, Daniel R, Breton, Marc D, DeBoer, Mark D
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Child; Child, Preschool; Diabetes Mellitus, Type 1 - therapy; Female; Focus Groups; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Insulin Infusion Systems; Male; Pancreas, Artificial - adverse effects; Quality Improvement; Artificial pancreas; Closed-loop systems; Pediatrics; Type 1 diabetes; Focus group; Human factors
• ISSN: 1557-8593
• DOI: 10.1089/dia.2017.0150

Artificial pancreas (AP) systems have initially been designed for and tested in teens and adults, but there is evidence that an AP system with additional support and safety systems could greatly benefit younger children with type 1 diabetes (T1D). Five pediatric endocrinologists and 15 parents of children aged 5-8 years with T1D participated in a total of four focus groups. Focus groups investigated current diabetes technology use and acceptance, as well as possible modifications to the current adult AP system, which would allow for safe and successful use in younger children. Modifications discussed include child-specific functionality for input tasks, safety features, and monitoring capabilities. Participant suggestions included the following: passcodes for differential access to AP features by parents, ancillary caregivers, and the child; preset early, intermediate, and advanced child access categories; maximal customization for general and alarm settings; simplified meal screens utilizing the AP' corrective blood glucose (BG) ability; automated exercise mode; spoken and dictated messaging capabilities; emergency contacts; treatment instructions for the child and caregiver; remote monitoring website and application; animated continuous glucose monitor BG trace; gamification, such as rewarding diabetes-friendly behaviors; and comprehensive training of all individuals involved in the child's diabetes care. Parents and physicians were eager for AP applications to be available for younger children, but stressed that a modified system could better serve this group's needs for safety and improved diabetes-related communication. The diverse and emerging needs of 5-8-year olds require flexible and customizable systems for T1D management.