A qualitative enquiry into the lived experiences of women with type 1 diabetes using closed-loop insulin delivery in pregnancy in the CIRCUIT trial

IF 3.3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2026-10-15 Epub Date: 2026-06-11 DOI:10.1111/dme.70388

J. Hirtle, N. Goraya, A. Dunlop, J. Booth, D. S. Feig, J. Yamamoto, L. E. Donovan, K. H. Chaput, For the CIRCUIT Collaborative Group

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引用次数: 0

Abstract

Aims

This qualitative inquiry aimed to explore the lived experiences of pregnant women with self-management of type 1 diabetes (T1D) using closed-loop insulin delivery in the CIRCUIT trial⁹ to provide a qualitative overview of its impacts and improve the understanding of T1D experiences in pregnancy.

Methods

We used semi-structured, individual interviews with 18 CIRCUIT randomized trial participants. Two team members analysed verbatim transcripts using inductive thematic analysis.

Results

Four major themes emerged: 1. Independence and isolation; 2. Support is key; 3. Closed-loop impacts; and 4. Control and autonomy. Diabetes management during pregnancy was an emotionally overwhelming experience that was managed largely independently. Closed-loop was noted as a gamechanger for diabetes management during and after pregnancy. Participants felt the transition to and use of this technology would not have been possible without their healthcare team's support. Permeating all themes was the importance of control to achieve the best possible glycaemic outcomes for the health of their babies and autonomy over personal treatment decisions. The perceptions of loss of personal autonomy were associated with high anxiety.

Conclusions

Managing T1D while pregnant is an independent and isolating endeavour, due to the ‘invisible labour’ involved and the lack of knowledge about T1D management in personal networks. Support from partners and care providers alleviated stress. Experiences with intrapartum care providers who had limited T1D understanding were perceived as a challenge by some for maintaining autonomy. The closed-loop system was seen as a ‘gamechanger’ in T1D pregnancy management, with unanimous perception of positive impacts that far outweigh any challenges. Use of this closed-loop system has potential to vastly improve pregnancy experiences among those with T1D.

查看原文本刊更多论文

在CIRCUIT试验中，对1型糖尿病妇女在妊娠期间使用闭环胰岛素输送的生活经历进行定性调查。

目的：本定性研究旨在探讨在CIRCUIT试验中使用闭环胰岛素给药自我管理1型糖尿病（T1D）的孕妇的生活经历，以提供其影响的定性概述，并提高对妊娠期T1D经历的理解。方法：我们对18名CIRCUIT随机试验参与者进行了半结构化的个人访谈。两名小组成员使用归纳主题分析逐字分析文本。结果：出现了四个主要主题：1。独立和孤立；2. 支持是关键；3. 闭环的影响;和4。控制和自主。怀孕期间的糖尿病管理是一种情感上压倒一切的经历，在很大程度上是独立管理的。闭环被认为是妊娠期间和妊娠后糖尿病管理的改变者。参与者认为，如果没有医疗团队的支持，就不可能过渡到并使用这项技术。贯穿所有主题的是控制的重要性，以实现对婴儿健康的最佳血糖结果和个人治疗决策的自主权。丧失个人自主权的感觉与高度焦虑有关。结论：由于涉及“无形劳动”和缺乏个人网络中T1D管理知识，在怀孕期间管理T1D是一项独立和孤立的努力。来自伴侣和护理人员的支持减轻了压力。与有限的T1D理解的分娩期间护理提供者的经历被一些人认为是保持自主性的挑战。闭环系统被视为T1D妊娠管理的“游戏规则改变者”，人们一致认为其积极影响远远超过任何挑战。使用这种闭环系统有可能极大地改善T1D患者的妊娠经历。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”